Job Description
Job Title: Registered Nurse - Case Manager
Location: Edmonds, WA 98026
Contract: 13 weeks
Shift: Day 5x8-Hour (08:00am –16:30pm)
Description:
Must have active WA license to submit.
Open to MSW Care Manager (& have EITHER Associate clinical license or LCISW) or RN Care Managers.
Requires a master's in social work.
Must have case management and discharge experience. Utilization management experience is helpful but not required.
Skills:
1.) General Skills Exp:
- Acute Hospital, Patients with Communication Prob (Hearing/Speech), Community Programs (Income/Insurance), Community Based Service Programs, APS (REQUIRED).
- Advance Directives, Americans with Disabilities Act, High-Risk Intervention, Patient Vulnerability or Safety Risk, Knowledge of Cultural Issues, NASW Code of Ethics/Standards of Home Health Care, CPS, Emergency Detention, Adopt/Foster Care, Suicide/Homicide/Self-Harm (PREFERRED).
2.) Case Management/Assessment Exp:
- Admission Criteria, Conduct an initial evaluation, Develop Plan of Care/Care coordination, Discharge Planning, Utilize InterQual Criteria, Utilize Milliman Guidelines, Appeals and Denials, Concurrent Review, Continued Stay Reviews, Medical Necessity, Retrospective Review, (REQUIRED).
- Assess Response to Treatment, Biopsychosocial Assessment, Geriatric Depression Scale, Mini-Mental State Examination (PREFERRED).
3.) Care Coordinator Exp :
- Coordinate Services: Home Care, Document Info to Facilitate Care Coordination, Participates in Care Conference Activities, Referrals to Rehab and LTC Facilities, Refers to Other Disciplines and Resources (REQUIRED)
4.) Documentation/Communication Exp:
- Documentation According to Plan of Care, Documentation of Care Delivery/Plan/Goals/etc. Documentation Reflects Understanding of Coverage Criteria (REQUIRED)
- Preferred: Discharge summary, documentation of patient/caregiver teaching and learning.
5.) Major Disease Processes Exp:
- Dementia, Stroke (REQUIRED).
- Cancer, CHF, COPD, Diabetes, HIV/AIDS, Immune Deficiency, Neurological Disorders, Paralysis, and Psychiatric Disorders (PREFERRED).
REGULATORY (REQUIRED):
CMS: Centers for Medicare and Medicaid Services, CPT (Current Procedural Terminology) coding and billing, Department of Health, DRG (Diagnosis Related Groups), HEDIS (The Healthcare Effectiveness Data and Information Set) Measures, HIPAA (The Health Insurance Portability and Accountability Act), ICD 10 Coding, NCQA (National Committee for Quality Assurance), OSHA: Occupational Safety and Health Administration, The Joint Commission/Core Measure/National Safety Goals, Worker’s Compensation.
CHARTING (REQUIRED):
Epic, Cerner
CERTS : BCLS required.
Skills : Med Surg Acute Care Required.
Float : yes, Case manager responsibilities include care coordination, and discharge planning.
Job Tags
Contract work, Shift work,