Description

American Traveler is seeking an experienced RN Case Manager with complex case management background, including NCQA experience, for a 13-week travel contract in the Washington, DC area.

Details

• Full-time day shift schedule, 5x8 hours (8:00–16:30), Monday through Friday
• No on-call or weekend requirements
• Remote/telephonic case management role with potential field visits up to 2 days per week (mileage reimbursed)
• Patient population includes members with chronic conditions such as high-risk pregnancy, postpartum, diabetes, CHF, COPD, asthma, obesity, and behavioral health diagnoses
• Case managers contact enrollees in the Washington, DC area to conduct comprehensive assessments, develop care plans, and provide ongoing management
• EMR used is Guiding Care/HealthEdge
• Local candidates in the DC area are preferred; candidates residing within 60 miles of the facility are subject to a local pay rate

Requirements

• Active DC RN license required prior to start date; pending DC RN license accepted for consideration with proof of pending status required
• Current BLS certification required
• Minimum 2 years of experience as a complex case manager required
• Experience required in acute hospital, long-term acute care, rehab, or skilled nursing settings
• Experience required in admission criteria, care coordination, discharge planning, and applying InterQual and Milliman guidelines
• Regulatory knowledge required: CPT codes, Department of Health DRGs, HEDIS measures, NCQA, OSHA procedures, and JCC
• NCQA experience strongly preferred
• 2 professional supervisory references from within the past 2 years required for consideration
• Full 7-year work history with all gaps explained required for consideration

Additional Information

• Business casual dress code required
• Previous charge nurse experience is preferred
• First-time travelers will be considered; a strong clinical background is expected
• Any time-off or scheduling requests must be submitted at the time of initial application
• BSN should be listed in credentials if applicable