Travel Nurse RN - Case Manager in Oakland, CA

**Job Title:** Registered Nurse
**Job Specialty:** Case Manager
**Job Duration:** 13 weeks
**Shift:** Day 5x8-Hour (08:00 - 16:30)
**Guaranteed Hours:** Not specified
**Experience:** Acute hospital discharge planning experience preferred; inpatient acute rehabilitation experience preferred
**License:** CA RN License
**Certifications:** BLS, ACLS
**Must-Have:** 2 years of experience, Epic experience preferred
**Job Description:**
- Coordinate utilization management, resource management, discharge planning, post-acute care referrals, and care facilitation.
- Oversee management of acute patient populations across the care continuum, focusing on providing coordinated and integrated care.
- Provide discharge planning coordination and intervention for high-risk patients presenting to the Emergency Department.
- Promote patient wellness, improved care outcomes, efficient health services utilization, and minimized denials of payment.
- Conduct patient initial and concurrent screening and review physician admission care plans.
- Gather additional medical, psychosocial, and financial information through patient/family interviews and medical record assessments.
- Determine moderate or high-risk levels for readmission and conduct screenings for ancillary supportive services.
- Supervise and lead health care teams in developing comprehensive, cost-effective care coordination plans.
- Perform cost-benefit analysis of care options and formulate transition plans based on available care options.
- Complete initial InterQual review screenings upon admission, document status, and ensure patient meets level of care requirements.
- Collaborate with financial counselors on inpatient stay denials and assure delivery of Medicare Important Message within required time.
- Participate in patient rounds and collaborate with the interdisciplinary team for timely discharge.
- Utilize InterQual criteria for admissions to determine appropriateness of the admission, setting, and level of care.
- Facilitate and expedite discharge of patients from the Emergency Department to alternate care settings.
- Document consistently in the Electronic Health Record and maintain knowledge of medical facility and discharge requirements.
- Initiate timely communication with admitting physicians for medical necessity deficiencies and identify avoidable admissions.
- Perform initial screenings on all hospitalized patients, document assessments, and communicate findings to the health care team.
- Identify barriers to discharge, work with a multi-disciplinary team to expedite care, monitor length of stay, and facilitate discharge.
- Address complex clinical and social situations to avoid unnecessary delays in discharge and transition plan completion.