Description

American Traveler is seeking an experienced RN Case Manager with inpatient case management experience and an active CA RN license for a primarily virtual role supporting complex cases across a health system and the community.

Details

• Primarily virtual position supporting complex cases across the health system and patients in the community
• Occasional floating required between offices in Emeryville and San Francisco
• Works across acute hospital and ambulatory settings
• Day shift schedule: 5x8s, 8:00 AM–4:30 PM
• Case management responsibilities include discharge planning, concurrent review, continued stay reviews, utilization review, prior authorizations, care coordination, admission criteria evaluation, and disease management
• Patient ratio of 1:25
• Epic EMR required
• Teaching hospital experience required
• Community hospital experience required

Requirements

• Active CA RN license required
• BLS certification required (AHA or ARC)
• Minimum 2 years of inpatient case management experience required
• Travel nursing experience required
• Epic EMR proficiency required
• Experience with InterQual Criteria, DRG, CMS, and HIPAA guidelines required
• Teaching hospital and community hospital experience required
• Trauma Level I or II experience preferred
• Charge nurse experience preferred
• Ambulatory, behavioral health, and telephonic case management experience preferred
• 2 supervisor references obtained within the past year required for consideration
• 7-year work history verification required

Additional Information

• Responsibilities include utilization review, medical necessity determinations, retrospective review, plan of care development, needs assessment, DME ordering, and benefits eligibility evaluation
• Knowledge of CMS, DRG, HIPAA, and Joint Commission/Core Measures/National Safety Goals expected
• Preferred specialty experience includes behavioral health, ED, ICU, SDU/PCU/IMC/Obs, and surgical services
• Local candidates are accepted; candidates must reside more than 50 miles from the facility to qualify for travel pay rates
• Former employees or travelers may return without a required separation period; former manager's name must be provided on the application (note: recruiter notes indicate a 1-year separation may apply — confirm with your recruiter)
• RTO is limited to a maximum of 7 days per contract; only 1 holiday may be requested off per contract
• Holidays with coverage expectations include New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day
• Any background or licensure disclosures must be accompanied by supporting documentation for facility HR review