Travel RN - Case Management/Utilization Review - Case Management

American Traveler, LLC.; Edmonds (WA); On-site; USD 85,000 - 120,000; Full time

Benefits offered by this job

High Pay and Bonuses

Medical, Dental and Vision Insurance (

Job summary

American Traveler, LLC. is seeking an RN Case Manager for an acute care hospital setting in Washington. The role requires 2+ years of acute care/med-surg experience and Epic EMR proficiency.

The position includes day shift hours (8:00 AM–4:30 PM), potential weekend coverage, and responsibilities spanning admission criteria review, care coordination, discharge planning, and regulatory compliance with CMS, HIPAA, ICD-10, DRG, and HEDIS standards. Open to first-time travelers.

Qualifications

• Active WA or compact RN license in hand at time of consideration.
• BLS certification required.
• Minimum 2 years of acute care/med-surg experience required.
• Epic EMR experience required.
• 2 professional references covering 1 year of experience within the last 3 years required for consideration.

Responsibilities

• Acute hospital setting in the Case Management/Utilization Review department.
• Day shift schedule, 5x8 hours (8:00 AM - 4:30 PM), primarily Monday-Friday with some weekend coverage required.
• Responsibilities include admission criteria review, care coordination, concurrent review, continued stay reviews, discharge planning, and utilization review.
• Utilizes InterQual Criteria and Milliman Guidelines for medical necessity determinations.
• Uses Epic EMR system.
• Case management duties include appeals and denials, medical necessity determination per evidence-based guidelines, and regulatory compliance (CMS, HIPAA, ICD-10, DRG, HEDIS, NCQA, OSHA, Joint Commission standards).
• Holiday coverage expected for 1 of 3 major holidays (Thanksgiving, Christmas, New Year's).
• Travelers may be required to float between sister facilities near the contracted location.
• First-time travelers are welcome to apply.
• Previous permanent employees of any Providence-affiliated facility must be separated from the health system for a minimum of 3 months to qualify.
• Local candidates accepted.
• Candidates residing within 50 miles of the facility may be subject to a different pay structure.

Skills

RN licensure

Epic EMR

Care coordination

Regulatory compliance

Education

Registered Nurse license (WA) or Compact

Tools

InterQual Criteria

Milliman Guidelines

Job description

American Traveler is hiring an RN Case Manager for an acute care hospital setting, requiring 2+ years of acute care/med-surg experience and Epic proficiency.

Requirements

• Active WA or compact RN license required in hand at time of consideration


• BLS certification required


• Minimum 2 years of experience required


• Acute care/med-surg experience required


• Epic EMR experience required


• 2 professional references covering 1 year of experience within the last 3 years required for consideration

Responsibilities

• Acute hospital setting in the Case Management/Utilization Review department


• Day shift schedule, 5x8 hours (8:00 AM - 4:30 PM), primarily Monday-Friday with some weekend coverage required


• Responsibilities include admission criteria review, care coordination, concurrent review, continued stay reviews, discharge planning, and utilization review


• Utilizes InterQual Criteria and Milliman Guidelines for medical necessity determinations


• Uses Epic EMR system


• Case management duties include appeals and denials, medical necessity determination per evidence-based guidelines, and regulatory compliance (CMS, HIPAA, ICD-10, DRG, HEDIS, NCQA, OSHA, Joint Commission standards)


• Holiday coverage expected for 1 of 3 major holidays (Thanksgiving, Christmas, New Year's)


• Travelers may be required to float between sister facilities near the contracted location


• First-time travelers are welcome to apply


• Previous permanent employees of any Providence-affiliated facility must be separated from the health system for a minimum of 3 months to qualify


• Local candidates accepted


• Candidates residing within 50 miles of the facility may be subject to a different pay structure

Benefits

• High Pay and Bonuses


• Medical, Dental and Vision Insurance with Day 1 Options


• 401(k) Plan


• Weekly Payroll Deposit


• Free Online CEUs


• Generous Housing Allowance


• Travel and Licensure Reimbursements


• Non-taxed Per Diem and Subsidy


• Traveler Rewards and Discounts

Job ID: P-766203

Open Positions: 1