Travel RN - Case Management/Utilization Review - Case Management

American Traveler is seeking an experienced RN for a Care Management position requiring a MA RN license, a minimum of 3 years of experience, and a BSN. Job Details • Acute inpatient hospital setting, Care Management department, • Manages a caseload of 18-22 patients on the Menino Campus, • Utilizes InterQual screening tools for determining medical necessity and appropriateness of admission, • Epic EMR experience preferred, • Schedule is 4x10-hour day shifts per week with no set day off, • Every 6th weekend required on an as-needed basis, • No major holiday coverage required, • 40 hours per week, Job Requirements • Active MA RN license required, • BSN required, • CCM or related certification preferred, • Minimum 3 years of experience in Care Management with extensive background in MS patterns of practice and acute inpatient care, • 5+ years of experience in utilization management (UM) and case management (CM) preferred, • Knowledge of methods for assessing physical and mental impairment, characteristics of illness, and expected treatment approaches, • Knowledge of benefits, plan contracts, eligibility issues, and requirements, • Epic EMR experience preferred, • Two professional references required: at least one must be from a manager-level or above (title must reflect 'Manager,' not 'Supervisor'), with performance evaluations included; one must be within the past 12 months and the other within 3 years, • References from other travelers are not accepted, • Copy of driver's license required for consideration, • Must pass the Relias Advanced Dysrhythmia Test (Test A or B); test may only be taken twice, Additional Information • Responsibilities include assessing, planning, implementing, monitoring, and evaluating options and services required to meet patient health needs using a collaborative process, • Focuses on managing length of stay (LOS), promoting efficient resource utilization, and achieving quality, cost-effective outcomes, • Determines medical necessity and appropriateness of admission using InterQual screening and inpatient lists from Medicare, • No radius restriction applies to this specialty; local candidates are accepted