RN - Case Manager (Days) - Pittsfield, MA #38850

Summary:

 • Ref #: 38850

 • Profession: Registered Nurse

 • Specialty: Case Manager

 • Job Type: Contract/Travel

 • Start Date: ASAP

 • Location: Pittsfield, MA

 • Shift Schedule: 8 hrs per day; 7:00 AM - 3:30 PM

 • Weekend Requirements: None

 • Shift Type: Days

 • Rate: $2,411/40-hours

Requirements: 

 • 3+ years of clinical experience in acute care in areas such as internal medicine, surgery, orthopedics, mother/child, cardiology, and oncology.

 • 3+ years of clinical experience in a Rehab Setting, Home Health, and Long-Term Care would be considered.

 • Ability to perform a comprehensive admission and discharge risk assessment related to quality, financial, payer benefit allowances and limitations, risk management, and patient satisfaction.

 • Knowledge of regulatory and accreditation organizations such as Joint Commission, DPH, and Health Grades preferred

 • CASEMGMT - CCM (Certified Case Manager), or ACM (Accredited Case Manager) or RN-BC (Registered Nurse, Board Certification in Case Management)

 • Experience specializing in utilization management (levels of care knowledge and demonstrable competence with evidence-based criteria tools), discharge planning to entities throughout a continuum of care, previous care management, or third-party insurance review 

 • Current knowledge of CMS (levels of care determinations), appeal rights & DPH regulations 

 • Current knowledge of Ma Pro QIO (appeals) 

 • Massachusetts license

 • BLS (AHA)