Travel RN - Case Management/Utilization Review - Case Management

American Traveler, LLC.; Atlanta (GA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

High pay/bonuses

Insurance from day 1

401(k) plan

Weekly payroll

Free online CEUs

Job summary

American Traveler is seeking an RN Case Manager for a 12-week acute hospital assignment in Atlanta, GA. The role requires at least 3 years of case management and prior travel nursing experience, with licensure to practice in GA or a Compact state.

The position focuses on discharge planning, utilization review, and ensuring appropriate levels of care, with a day shift and no weekends. Candidates must meet all clinical requirements and pass a screening prior to interview.

Qualifications

• Active RN license (GA or Compact) required.
• Minimum 3 years of case management experience required.
• Prior travel nursing experience required.
• Teaching hospital and community hospital experience preferred.
• Experience with InterQual Criteria and Milliman Guidelines.
• Knowledge of CMS, DRG, ICD-10 coding, HIPAA, and regulatory compliance standards.
• Experience with admission criteria, concurrent review, continued stay reviews, and medical necessity determinations.
• Experience with appeals and denials and retrospective review processes.
• Charting system experience required.

Responsibilities

• Acute hospital setting within the Case Management/Utilization Review department.
• Responsible for assessing, evaluating, and driving discharge plans.
• Coordinates services to ensure patients receive appropriate level of care.
• Monitors treatment plans daily and identifies barriers to discharge.
• Follows Medicare regulatory guidelines regarding patient choice, IMM notices, and MOON notices.
• Schedule is Monday-Friday, day shift (5x8 hours, 8:00 AM-4:30 PM).
• No weekend or call requirements.
• Floating required within facility and scope of practice as needed.
• Candidates undergo a clinical screening to determine fit before being presented to the hiring manager for final decision.
• First-time travelers are not accepted for this position.
• Maximum RTO of 7 days per contract, with requests to be discussed during interview.
• No RTO requests accepted during September per manager request.
• Holiday coverage required based on number of major holidays falling within the assignment period.
• Major holidays include Memorial Day, Independence Day, Labor Day, Thanksgiving/Black Friday, and Christmas Eve/Christmas Day, and New Year’s Eve/New Year’s Day.
• Full compliance required by start date to avoid a two-week delay due to bi-weekly orientation scheduling.
• Local candidates accepted at the same bill rate.
• Previous permanent, PRN, or internal staff must be away from all facilities within the health system for one full year before returning as a traveler.
• Travelers who cancel or are deemed unable to return to a facility must complete one successful assignment elsewhere before reapplying.

Skills

RN license GA/Compact

BLS Certification

Case management experience

Travel nursing experience

CMS/DRG/ICD-10 knowledge

HIPAA/regulatory compliance knowledge

Admission criteria/concurrent review/…

Appeals/denials/review processes

Charting system proficiency

Job description

American Traveler is hiring an RN Case Manager for a 12-week acute hospital assignment requiring at least 3 years of case management experience and prior travel experience.

Requirements

• Active RN license (GA or Compact) required
• BLS certification required
• Minimum 3 years of case management experience required
• Prior travel nursing experience required
• Teaching hospital and community hospital experience preferred
• Experience with InterQual Criteria and Milliman Guidelines
• Knowledge of CMS, DRG, ICD-10 coding, HIPAA, and regulatory compliance standards
• Experience with admission criteria, concurrent review, continued stay reviews, and medical necessity determinations
• Experience with appeals and denials and retrospective review processes
• Charting system experience required

Responsibilities

• Acute hospital setting within the Case Management/Utilization Review department
• Responsible for assessing, evaluating, and driving discharge plans
• Coordinates services to ensure patients receive appropriate level of care
• Monitors treatment plans daily and identifies barriers to discharge
• Follows Medicare regulatory guidelines regarding patient choice, IMM notices, and MOON notices
• Schedule is Monday-Friday, day shift (5x8 hours, 8:00 AM-4:30 PM)
• No weekend or call requirements
• Floating required within facility and scope of practice as needed
• Candidates undergo a clinical screening to determine fit before being presented to the hiring manager for final decision
• First-time travelers are not accepted for this position
• Maximum RTO of 7 days per contract, with requests to be discussed during interview
• No RTO requests accepted during September per manager request
• Holiday coverage required based on number of major holidays falling within the assignment period
• Major holidays include Memorial Day, Independence Day, Labor Day, Thanksgiving/Black Friday, and Christmas Eve/Christmas Day, and New Year's Eve/New Year's Day
• Full compliance required by start date to avoid a two-week delay due to bi-weekly orientation scheduling
• Local candidates accepted at the same bill rate
• Previous permanent, PRN, or internal staff must be away from all facilities within the health system for one full year before returning as a traveler
• Travelers who cancel or are deemed unable to return to a facility must complete one successful assignment elsewhere before reapplying

Benefits

• High Pay and Bonuses
• Medical, Dental and Vision Insurance with Day 1 Options
• 401(k) Plan
• Weekly Payroll Deposit
• Free Online CEUs