Description

American Traveler is seeking an experienced RN Case Manager for a hospital case management/utilization review role requiring 3+ years of experience and prior travel assignment history.

Details

• Acute hospital setting within the Case Management department
• Responsible for assessing, evaluating, and driving patient discharge plans
• Coordinates services to ensure patients receive appropriate level of care
• Monitors treatment plan progress daily and identifies barriers to discharge
• Follows Medicare regulatory guidelines including patient choice, IMM notices, and MOON notices
• Day shift schedule, Monday through Friday, 8:00 AM to 4:30 PM
• No weekend or call requirements
• Floating required within facility and scope of practice as needed

Requirements

• Active GA or Compact RN license required at time of consideration
• BLS certification required
• Minimum 3 years of case management experience required
• Prior travel nursing experience required
• Experience with any charting system required
• Teaching hospital experience preferred
• Community hospital experience preferred
• Knowledge of InterQual Criteria and Milliman Guidelines
• Familiarity with utilization review processes including admission criteria, appeals and denials, concurrent review, and medical necessity determinations
• Understanding of regulatory standards including CMS, HIPAA, ICD-10 coding, DRG, and Joint Commission requirements
• Two supervisory references (Manager level or above) highly preferred for consideration

Additional Information

• Coordinate discharge planning and care coordination for assigned patients
• Conduct utilization review activities including continued stay reviews and retrospective reviews
• First-time travelers are not considered for this position
• Local candidates accepted at the same bill rate
• Previous Piedmont employees must be away from all Piedmont facilities for one full year before returning as a traveler
• Travelers who cancelled or received a DNR must complete one assignment outside Piedmont before reapplying
• Maximum RTO of 7 days per contract, with all requests finalized prior to start
• No RTO permitted during orientation week
• Holiday coverage required based on number of major holidays falling within the assignment period
• Shift and schedule are firm with no alternate requests accepted
• Travel pairs cannot be assigned to the same shift on the same unit
• Full compliance required to start on time; incomplete compliance may result in a two-week delay due to biweekly orientation scheduling