RN-Case Manager

Admission Criteria,Disease management,Needs Assessment/ Order DME,Acute Hospital,Care coordination,Discharge Planning,Medical Necessity,CMS: Centers for Medicare and Medicaid Services,DRG (Diagnosis Related Groups),HIPAA guidelines (Health Insurance Portability and Accountability Act)Utilize InterQual Criteria,Utilize InterQual Criteria,Insurance Company,Behavioral Health,Emergency Department,ICU,MS,NICU,Pediatrics,PICU,SDU/PCU/IMC/Obs,Surgical Services,Women’s Services,Appeals and Denials,Benefits Eligibility,Determine Medical Necessity per Evidence-Based Guidelines,Prior Authorizations,Worker’s comp case management,Admission Criteria,Behavioral Health,Home Health,Hospice,Long Term Acute Care/Rehab/Skilled Nursing,Plan of Care,Workers Compensation