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Job description
Prime Time Healthcare Nursing is seeking a travel nurse RN Care Manager for a travel nursing job in Hyannis, Massachusetts.Job Description & Requirements
Specialty:
Care Manager
Discipline:
RN
Duration:
13 weeks36 hours per week
Shift:
12 hours, days
Employment Type:
TravelRN Case Manager – Cape Cod Hospital
Location:
Massachusetts
Setting:
Acute-care hospital
Specialty:
Case Management, Utilization Review and Discharge Planning
Required Skills:
Acute-care experience and InterQual
Required Qualifications
Active Massachusetts RN license
Minimum 3 years of acute-care hospital or case-management experience within the past 5 years
Recent discharge-planning and utilization-review experience within the past 4 years
Working knowledge of InterQual or a comparable system
Strong knowledge of payer and regulatory requirements
Proficiency with electronic documentation and healthcare softwareBSN preferred
Case Management, CPUM or related specialty certification preferred
Primary Responsibilities
Screen new admissions daily for discharge-planning needs
Complete identified initial assessments within one business day
Document initial assessments and continued-stay reviews using InterQualReassess patients approximately every three days or when clinical or caregiver circumstances changeDetermine the appropriate inpatient or observation level of carePerform utilization review for the assigned unitMonitor length of stay and identify cases at risk for denialRefer cases to the physician advisor when medical-necessity criteria are not metIssue HINN notices and reinstatement letters when appropriateCoordinate discharge appeals and explain adverse coverage decisionsCommunicate concurrent clinical information to third-party payersCollaborate with physicians and the interdisciplinary care teamParticipate in daily rounds and patient-care conferencesDevelop safe discharge plans and coordinate transfers to facilities, agencies and community resourcesAddress complex psychosocial, financial and legal needs through appropriate referralsSupport medical coding by obtaining required diagnostic and procedural informationEnsure care plans align with patient needs, available benefits and covered services
Ideal Candidate
The successful RN will be highly organized, comfortable working independently and able to manage changing priorities in a fast-paced hospital environment. Strong communication, negotiation, patient advocacy and interdisciplinary collaboration skills are essential.
About Prime Time Healthcare Nursing
Prime Time Healthcare is a leading provider of traveling healthcare professionals nationwide. Our agency specializes in the placement of RNs, LPNs, CNAs, and Allied Health professionals. Join the fun and experience why healthcare professionals and client facilities are joining the Prime Time TEAM.
Benefits
401k retirement planHealth savings accountReferral bonusMedical benefitsDental benefitsVision benefits
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Worksite address
hyannis, MA, 02601, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.