RN - Case Management

Origin Travel Nurses; Torrance (CA); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health benefits

Onboarding support

Clinical team

401k match

Recruiter matching

Travel reimbursement

Housing allowance

Meal incentives

Job summary

Origin Travel Nurses is seeking a Case Manager responsible for utilization review and case management in a hospital setting. You will perform chart reviews, quality assessments, and ensure appropriate discharges while adhering to InterQual SI/IS criteria.

You will educate physicians and staff, initiate Medi-Cal TARs at admission, and document daily. This role requires clinical and case management experience, plus BCLS certification, servicing a California facility.

Qualifications

• Two years of clinical experience.
• Two years of case management experience or certification in case management.
• Current BCLS certification.

Responsibilities

• Perform chart reviews and quality assessments using SI and IS InterQual criteria.
• Identify and implement case management interventions for complex cases.
• Monitor observation cases to ensure timely discharge or inpatient admission decisions.
• Initiate Medi-Cal TARs at admission and document daily using SI and IS criteria.
• Evaluate the case management plan in response to changing patient care situations.
• Educate physicians and hospital staff on utilization management criteria.
• Prepare documentation for denial letters and assist in appeals processes.
• Address complex patient situations with problem-solving skills.
• Identify inappropriate bed utilization and quality of care issues for referral to physician advisor.

Skills

Clinical experience

Case management

BCLS

Education

Case management certification

Job description

The Case Manager is responsible for utilization review and case management activities within the hospital. This position involves performing chart reviews, quality assessments, and ensuring appropriate patient discharges while adhering to the established criteria.

Responsibilities

• Perform chart reviews and quality assessments on all patients using Severity of Illness (SI) and Intensity of Service (IS) InterQual criteria.
• Identify and implement case management interventions for cases with less predictable outcomes.
• Monitor observation cases to ensure timely discharge or admission for inpatient services.
• Initiate Medi-Cal TARs at admission and document daily using SI and IS criteria.
• Evaluate the case management plan in response to changing patient care situations.
• Educate physicians and hospital staff on criteria for utilization management.
• Prepare documentation for denial letters and assist in the appeals process.
• Address complex patient situations with innovative problem-solving skills.
• Identify inappropriate bed utilization and quality of care issues for referral to the physician advisor.

Required Experience / Certifications / Licensure

• Two years of clinical experience.
• Two years of case management experience or certification in case management.
• Current BCLS certification.

Why ARMStaffing?

• Health Benefits: Medical, Dental, Vision, Life, and more
• Onboarding Made Easy: We handle physicals, titers, and more so you can focus on care
• Clinical Support: In-house clinical team available to assist and advocate
• 401k Retirement Plan: Eligible after waiting period; 4% match with 5% contribution
• Recruiter Matching: Get paired with a recruiter based on your location and specialty
• Extras: Travel reimbursement, housing allowance, meals, referral bonuses, and more

Location: CA 90505