What are the responsibilities and job description for the Registered Nurse - Case Manager position at TALENT Software Services?
Duties
- Perform care coordination and admission reviews.
- Manage discharge planning and oversee patient caseloads up to 25.
- Participate in the development of treatment plans and family meetings.
- Coordinate with interdisciplinary support teams including IV teams, physical therapy, and social services.
- Ensure compliance with Medicare guidelines and arrange necessary DME, SNF, and ambulance transport.
- Work on weekends with rotation, overseeing up to 2 units focusing on discharge planning.
- Competence in InterQual guidelines and admission criteria.
- Ability to determine medical necessity per evidence-based guidelines.
- Experience with appeals and denials, prior authorizations, and benefits eligibility.
- Proficiency in computerized documentation systems.
- Familiarity with workers' compensation, HIPAA guidelines, and CMS regulations.
- Minimum of 2 years in acute care case management or discharge planning.
- Experience in various work settings including behavioral health, home health, and acute hospitals.
- First-time travelers are welcome, but must be screened.
- California state license required; pending license accepted if licensed upon start date.
- Weekend coverage required every other weekend, must be available for holidays.
Salary : $50 - $55