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Case Management - Registered Nurse - $2,565 per week
Los Angeles, United States
Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides more transparency, eliminates pesky calls from recruiters, and puts more money in your pocket. Join the thousands of nurses across the country who have already made the switch to a more modern way to work.
Shift: 8:00 AM - 4:30 PM
Experience
Additional Details
Required Skills/Experience: Acute care hospital experience in both UM and Care Coordination (discharge planning). 2-year acute medical Care Manager experience performing both roles of Care Coordination and Utilization Review. INTERQUAL is a HARDSTOP.
Acute Hospital Case Management/Utilization Review
Admission Criteria Care coordination Concurrent Review Continued Stay Reviews Determine Medical Necessity per Evidence-Based Guidelines Discharge Planning Needs Assessment/ Order DME Plan of Care Utilize InterQual Criteria Utilization Review
Admission Criteria Concurrent Review Continued Stay Reviews Medical Necessity Acute Hospital Experience by Specialty
CMS: Centers for Medicare and Medicaid Services Additional Skills
Extra Checklist/grid W/ Required Skills
Preferred Skills/Experience: Appeals and Denials* Benefits Eligibility* Disability case management*
Prior Authorizations* Utilize InterQual Criteria Utilize Milliman Guidelines* Worker’s comp case management*
Appeals and Denials*
CPT (Current Procedural Terminology) coding and billing*
Behavioral Health* Pre-Cert Review* Prior Authorization* Quality Improvement* Retrospective Review* Utilize InterQual Criteria Utilize Milliman Guidelines*
ER* ICU* MS* NICU* Pediatrics* PICU* SDU/PCU/IMC/Obs* Surgical Services* Womens Services*
CMS: Centers for Medicare and Medicaid Services CPT (Current Procedural Terminology) coding and billing* Department of Health* DRG (Diagnosis Related Groups)* HEDIS (The Healthcare Effectiveness Data and Information Set) Measures* HIPAA guidelines (Health Insurance Portability and Accountability Act)* ICD 10 Coding* NCQA (National Committee for Quality Assurance)* OSHA: Occupational Safety and Health Administration* The Joint Commission/ Core Measure/National Safety Goals* Worker’s Compensation*
Required Credentials: References must cover at least 1 full year of relevant experience in specialty within the past 3 years. Cannot have any hits/suspensions on license or any background hits from any point in the past. Should have extra checklist w/ NURSYS.
Types of Patients on Unit: Patient Age Groups: Adults, Geriatrics.
Procedures/Diagnostics/Treatments Performed on Unit:
Unit/Facility Details: All positions at Providence Health & Services require that any and all lab items requested during onboarding be completed within 72 hours of signing a contract - no exceptions. This means candidates must be responsive and willing to go to a lab to complete health orders ASAP after signing. Failure to comply may lead to a pushed start or cancellation as assessed by the facility. Can screen 1st time traveler.
Shift & Scheduling: Weekend Requirements - CM All CMs, including travelers should rotate every other weekend.
Floating Requirements: ALL travelers are expected to float between all facilities within a given state. travelers’ refusal to float may result in termination of assignment and/or forfeiture of guaranteed hours.
5 days maximum time off
2 references from last 2 years (Manager/Supervisor reference type) - required for submission
Certifications
Shift: 8:00 AM - 4:30 PM
Experience
- 12 months of role experience is required with some in the last 12 months.
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Must have at least 22 months of Case Management experience.
- Candidates must have a California license (required for submission).
- This role may require floating to additional units and locations
- Travel only, local not allowed. Candidates must live >50 miles from facility to be submitted.
- COVID vaccination required after submission. Religious and medical declinations accepted.
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Flu vaccination required after submission. Religious and medical declinations accepted.
Additional Details
Required Skills/Experience: Acute care hospital experience in both UM and Care Coordination (discharge planning). 2-year acute medical Care Manager experience performing both roles of Care Coordination and Utilization Review. INTERQUAL is a HARDSTOP.
Acute Hospital Case Management/Utilization Review
Admission Criteria Care coordination Concurrent Review Continued Stay Reviews Determine Medical Necessity per Evidence-Based Guidelines Discharge Planning Needs Assessment/ Order DME Plan of Care Utilize InterQual Criteria Utilization Review
Admission Criteria Concurrent Review Continued Stay Reviews Medical Necessity Acute Hospital Experience by Specialty
CMS: Centers for Medicare and Medicaid Services Additional Skills
Extra Checklist/grid W/ Required Skills
Preferred Skills/Experience: Appeals and Denials* Benefits Eligibility* Disability case management*
Prior Authorizations* Utilize InterQual Criteria Utilize Milliman Guidelines* Worker’s comp case management*
Appeals and Denials*
CPT (Current Procedural Terminology) coding and billing*
Behavioral Health* Pre-Cert Review* Prior Authorization* Quality Improvement* Retrospective Review* Utilize InterQual Criteria Utilize Milliman Guidelines*
ER* ICU* MS* NICU* Pediatrics* PICU* SDU/PCU/IMC/Obs* Surgical Services* Womens Services*
CMS: Centers for Medicare and Medicaid Services CPT (Current Procedural Terminology) coding and billing* Department of Health* DRG (Diagnosis Related Groups)* HEDIS (The Healthcare Effectiveness Data and Information Set) Measures* HIPAA guidelines (Health Insurance Portability and Accountability Act)* ICD 10 Coding* NCQA (National Committee for Quality Assurance)* OSHA: Occupational Safety and Health Administration* The Joint Commission/ Core Measure/National Safety Goals* Worker’s Compensation*
Required Credentials: References must cover at least 1 full year of relevant experience in specialty within the past 3 years. Cannot have any hits/suspensions on license or any background hits from any point in the past. Should have extra checklist w/ NURSYS.
Types of Patients on Unit: Patient Age Groups: Adults, Geriatrics.
Procedures/Diagnostics/Treatments Performed on Unit:
- Ability to organize and participate in family meetings.
- Participate in the development of the treatment plan.
- Experience with HMOs, IPAs, etc.
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Competent with arranging DME, SNF and ambulance transport. Must be able to perform this task independently.
Unit/Facility Details: All positions at Providence Health & Services require that any and all lab items requested during onboarding be completed within 72 hours of signing a contract - no exceptions. This means candidates must be responsive and willing to go to a lab to complete health orders ASAP after signing. Failure to comply may lead to a pushed start or cancellation as assessed by the facility. Can screen 1st time traveler.
-
Case Load up to 25 patients
Shift & Scheduling: Weekend Requirements - CM All CMs, including travelers should rotate every other weekend.
Floating Requirements: ALL travelers are expected to float between all facilities within a given state. travelers’ refusal to float may result in termination of assignment and/or forfeiture of guaranteed hours.
5 days maximum time off
2 references from last 2 years (Manager/Supervisor reference type) - required for submission
Certifications
- BLS (Basic Life Support)
- Skills Checklist: Yes
- References: Yes
- License Type: registered
- License State: CA
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Certifications: Basic Life Support
- Job Type: Travel
- Nurse/Patient: 1/20
- Shift Type: Day
- Contract Date: 2025-10-27
- Expected Length: 13 weeks
- Hours per Shift: 8
- Shifts per Week: 5
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