Case Management Nurse
Position : Case Manager
Location : REMOTE BUT MUST LIVE IN INDIANA!
Duration : 6-month contract with the possibility of going FTE
Start Date : May 6th, 2024
Monday - Friday 8 : 00 am - 5 : 00 pm
REMOTE with potential for travel onsite 3 - 4 times a year.
Position Summary :
The RN Case Manager plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team.
Ensures that patients are assigned the appropriate level of care, receive the appropriate services and are transitioned to the appropriate post-discharge level of care.
Performs accurate, timely and effective discharge planning for patients. Works with third-party payers to ensure coverage.
Administers education and prevention programs.
- Associate's OR Bachelors Degree in Nursing required.
- Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
- Certification in Case Management preferred.
- Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
- Knowledge of Medicare / Medicaid, insurance and regulatory guidelines is preferred.
- Ability to comprehend third party contractual arrangements is preferred.
- Understanding of the third party denial and appeal process is preferred.
- Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
- 3-5 years of experience preferred.
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