Travel Case Management RN — Day Shift (13-Week)

American Traveler; Philadelphia (Philadelphia County); On-site; USD 104,000 - 113,000; Full time

Job summary

American Traveler is hiring a Case Management RN for a hospital case management role requiring 3+ years of hospital case management experience and a compact or PA RN license. Day shift, 40 hrs/wk, 13 weeks, no weekends or on-call, uses Epic, business casual dress.

Active RN license (Compact or PA), BLS, BSN are required, plus 3+ years discharge planning. Familiarity with InterQual/Milliman criteria and CMS/HIPAA regulations is expected; PA fingerprint/Childline clearances may apply.

Qualifications

• Active RN license (Compact or PA)
• BLS certification
• BSN
• 3+ years hospital case management and discharge planning experience
• Experience with InterQual and Milliman utilization review criteria
• Knowledge of utilization review processes including admission criteria, appeals and denials, concurrent review, and medical necessity determinations
• Familiarity with CMS, HIPAA, ICD-10, DRG, Joint Commission requirements
• PA fingerprint clearance and Childline clearance
• Valid references and copies of certifications

Responsibilities

• Coordinate patient care, discharge planning, and utilization review activities for assigned caseload
• Apply InterQual and Milliman guidelines to support admission and continued stay reviews
• Collaborate with healthcare team to ensure regulatory compliance and quality care standards
• RTO and time-off considerations will be handled per policy
• Block scheduling cannot be accommodated
• Local candidates within 50 miles may receive different pay rates
• First-time travelers are welcome to apply
• Labs completed within 48 hours of contract signing
• Orientation modules completed within the first 8 hours of orientation

Skills

Case management

Discharge planning

Utilization review

CMS HIPAA knowledge

InterQual Milliman

Education

BSN

Tools

Epic

Job description

American Traveler is hiring a Case Management RN for a hospital case management role requiring 3+ years of hospital case management experience and a compact or PA RN license. Day shift, 40 hrs/wk, 13 weeks, no weekends or on-call, uses Epic, business casual dress.

Active RN license (Compact or PA), BLS, BSN are required, plus 3+ years discharge planning. Familiarity with InterQual/Milliman criteria and CMS/HIPAA regulations is expected; PA fingerprint/Childline clearances may apply.