Registered Nurse/Case Manager
IMCS Group
Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital. 6/16 start. 5 years' experience in specialty required. Epic & InterQual documentation; SBAR communication. Rotating weekends required.
Certifications REQUIRED: BLS; BSN; State License Skills/Experience REQUIRED: Acute Hospital; Long Term Acute Care/Rehab/Skilled Nursing; Admission Criteria; Care Coordination; Discharge Planning; Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and Denials; UR Concurrent Review; UR Continued Stay Reviews; UR Medical Necessity; UR Retrospective Review; UR Utilize InterQual Criteria; UR Utilize Milliman Guidelines; 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 guidelines (Health Insurance Portability and Accountability Act); ICD 10 Coding; NCQA (National Committee for Quality Assurance); OSHA; The Joint Commission/ Core Measure/National Safety GoalsWorkers Compensation
Vacancy posted 4 hours ago
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