RN Case Manager
Washington, DC
Prime Staffing
5x8 hrs

ID: 63056672 Shift: Day 5x8-Hour (08:00 - 16:30) Description: 2yrs CASE MANAGER 40HRS WEEKShift: 5 x 8 day 0800-1630Local Rate within 60 Miles of facilityOpen to Local candidate only located in the DC areaOn Call: NoneWeekend Requirement: NoneMust have experience as complex Case Manager, preferably NCQA experience.*Will be working out of MedStar Georgetown starting May 1.Position may require field visits 2 days per week. Will reimburse for mileage. Requirements:- Pending DC RN license accepted but MUST have license prior to start date (***Aya Paid OPEN LICENSE PROJECT***)-BLS- 2 years of experience required: Acute Hospital, Long Term Acute Care/Rehab/Skilled Nursing, Admission Criteria, experience in Care coordination, Discharge Planning, Utilizing InterQual Criteria, and Utilizing Milliman Guidelines; previous Charge experience preferred- Regulatory skills required: knowledge of CPT codes, Department of Health DRG, HEDIS measures, NCQA, OSHA procedures and JCC- *unit will take FIRST TIME TRAVELER* must present with strong backgroundUnit Information:- Chronic diagnoses (High Risk Pregnancy, Postpartum, DM, CHF, COPD, Asthma, obesity/overweight, All Behavorial Health, etc.)- CM make calls to enrollees in Washington DC area to complete comprehensive assessments, developing care plans, and ongoing management within the EMR (guiding care/Healthedge).- Dress Code: business casualPending DC license accepted***MUST provide proof of pending status at time of submission and***MUST have DC license in hand prior to start date***Aya Paid OPEN LICENSE PROJECT**Reference Job ID: 3259955 Modified Time:5/25/2026 5:00:00 AM Account Manager: Brooke Insko Account Manager Email: COVID-19 Vaccine: Not Required Flu Vaccine: Required - No Exemptions Submittals:High Job Requirements & Qualifications Previous Charge Experience : Preferred Years of Experience : 2 Patient Ratio Experience : 50 - 160 Charting System Experience : - Charting System Name : Community Hospital Experience : Preferred LTAC Experience : Preferred Trauma Level I Experience : Preferred Trauma Level II Experience : Preferred Travel Experience Required : - Certifications : BLS, DC License , CCM*Skills : Acute Hospital, Admission Criteria, Care coordination, CMS: Centers for Medicare and Medicaid Services, CPT (Current Procedural Terminology) coding and billing, Department of Health, Discharge Planning, DRG (Diagnosis Related Groups), HEDIS (The Healthcare Effectiveness Data and Information Set) Measures, HIPAA guidelines (Health Insurance Portability and Accountability Act), ICD 10 Coding, Long Term Acute Care/Rehab/Skilled Nursing, NCQA (National Committee for Quality Assurance), OSHA, The Joint Commission/ Core Measure/National Safety Goals, Utilize InterQual Criteria, Utilize Milliman Guidelines, Workers Compensation, NCQA knowledge/experience preferred* Unit Details Staffing & Scheduling Scheduling Type : block Patient Ratios Days : 5 Patient Ratios Nights : - Patient Ratios Weekends : - Float Required : n/a Call Required : n/a Weekend Coverage : - Number of Weekend Shifts Per Contract : n/a Pre-Approved Time Off : one Orientation Hours : 80 Facility & Patient Care Details Patient Age Groups : Neonates, Adolescents, Infants, Adults, Pediatrics, Geriatrics Daily Census : - Number of Visits Per Day : - Number of Rooms : - Number of Beds : - Additional Unit Information Interdisciplinary Support : Social Services, Transportation Patient Diagnoses : Chronic diagnoses (High Risk Pregnancy, Postpartum, DM, CHF, COPD, Asthma, obesity/overweight, All Behavorial Health, etc.) Special Procedures/Unit Details : Will need to make calls to enrollees in Washington DC area to complete comprehensive assessments, developing care plans, and ongoing management within the EMR (guiding care/Healthedge). Care plans must be individualized and address Social Determinants of Health (sDOH) needs. Must be able to collaborate with hospitals, physicians, etc. to ensure successful execution of the care plan. Documentation must reflect NCQA and contract requirements / timelines. Enrollees are Medicaid recipients, the most vulnerable population. Must be able and willing to care for Pregnant Persons/Newborns to Geriatric age groups. Special Equipment : Must be able to operate a computer, use WebEx system to make calls, be proficient with Microsoft suite. #Tier4 Travel Compliance Please review the following submittal requirements carefully: Local Guidelines The local radius is 60 miles . A candidate s address must match their driver s license when determining local status, and a copy of the driver s license must be provided at the time of submittal. Local candidates are accepted at a lower rate. Please reach out to the AM or EC for local rate information. Licensure (Required at Time of Submission) DC Locations: Must have a DC license in hand. Some units will accept a pending DC license (see job description to confirm). A later start date may be accepted if the traveler has applied for DC licensure. MD Locations: Must have either a compact license or an MD license. Some units will accept a pending MD license (see job description to confirm). A later start date may be accepted if the traveler has applied for MD licensure. References Two (2) supervisory references, including one from the most recent assignment are required. Must support at least 2 years of experience in the previous 3 years. RTO (Requested Time Off) No RTO is permitted during the first two weeks of the assignment. RTO must be included at the time of submittal and cannot be changed once the profile has been sent to the manager for review. Amount of RTO: No more than 7 days per 13-week contract. Certifications L D RNs: C-EFM NCC certification is required at the time of submittal. Return Staff Policy Nurses with previous MedStar employment must have been separated for a minimum of one year before returning as a traveler. Submittals Candidates may be submitted to only one MedStar location at a time. Interview Process Manager interviews are not guaranteed. Travelers must be comfortable proceeding without an interview. Any traveler questions should be directed to the AM. Clinical Review All submittals are reviewed by the clinical team, even if not listed on Aya Offer. Compliance Requirements Candidates are assigned facility-and unit-specific Sitel modules upon hire, which must be completed within one week of signing their contract. Failure to complete them within this timeframe may result in cancellation. Labs and DS appointment must be completed within 48 hours of signing. Failure to complete them within this timeframe may result in cancellation. Candidates are encouraged to plan ahead to prevent conflicts with vacations or work schedules. Candidates in the following specialties must pass the Relias EKG Rhythm Interpretation Exam for clearance, achieving at least an 80% overall score and 100% on lethal rhythms: BICU Cardiac Cardiac Stress Testing Cardiac Tele Cardio Thoracic ICU CCU COVID ICU Critical Care Bedside Monitor Critical Care Float Critical Care Transport CVICU CVPICU ECMO EP Lab ER ER Holding ICU IMC IR LTAC ICU LTAC MS Tele LTAC Telemetry MICU MS/Tele MS/Tele Float Neuro ICU NICU NICU Transport PCU PCU Float PCU/Oncology Pediatric Cardiology Pediatric Critical Care Float Pool Pediatric ER Pediatric MICU Pediatric PCU Pediatric Stepdown Pediatric Telemetry PICU SICU Stepdown Stepdown Cardiac Stepdown Neuro Tele Float Telemetry Trauma ICU Modules : Modules are billable up to 4 hours, any additional time beyond this is non-billable and must be margined. The average module duration is 12 hours. Modules are completed pre-start and potentially during orientation, and can vary by specialty Modules are recorded via transcripts Submittal Details: #Tier4 Travel CompliancePlease review the following submittal requirements carefully:Local GuidelinesThe local radius is 60 miles. A candidate s address must match their driver s license when determining local status, and a copy of the driver s license must be provided at the time of submittal.Local candidates are accepted at a lower rate. Please reach out to the AM or EC for local rate information.Licensure (Required at Time of Submission)DC Locations: Must have a DC license in hand. Some units will accept a pending DC license (see job description to confirm). A later start date may be accepted if the traveler has applied for DC licensure.MD Locations: Must have either a compact license or an MD license. Some units will accept a pending MD license (see job description to confirm). A later start date may be accepted if the traveler has applied for MD licensure.ReferencesTwo (2) supervisory references, including one from the most recent assignment are required. Must support at least 2 years of experience in the previous 3 years.RTO (Requested Time Off)No RTO is permitted during the first two weeks of the assignment.RTO must be included at the time of submittal and cannot be changed once the profile has been sent to the manager for review.Amount of RTO: No more than 7 days per 13-week contract.CertificationsL&D RNs: C-EFM NCC certification is required at the time of submittal.Return Staff PolicyNurses with previous MedStar employment must have been separated for a minimum of one year before returning as a traveler.SubmittalsCandidates may be submitted to only one MedStar location at a time.Interview ProcessManager interviews are not guaranteed. Travelers must be comfortable proceeding without an interview.Any traveler questions should be directed to the AM.Clinical ReviewAll submittals are reviewed by the clinical team, even if not listed on Aya Offer.Compliance RequirementsCandidates are assigned facility-and unit-specific Sitel modules upon hire, which must be completed within one week of signing their contract. Failure to complete them within this timeframe may result in cancellation.Labs and DS appointment must be completed within 48 hours of signing. Failure to complete them within this timeframe may result in cancellation. Candidates are encouraged to plan ahead to prevent conflicts with vacations or work schedules.Candidates in the following specialties must pass the Relias EKG Rhythm Interpretation Exam for clearance, achieving at least an 80% overall score and 100% on lethal rhythms:BICU Cardiac Cardiac Stress Testing Cardiac Tele Cardio Thoracic ICU CCU COVID ICU Critical Care Bedside Monitor Critical Care Float Critical Care Transport CVICU CVPICU ECMO EP Lab ER ER Holding ICU IMC IR LTAC ICU LTAC MS Tele LTAC Telemetry MICU MS/Tele MS/Tele Float Neuro ICU NICU NICU Transport PCU PCU Float PCU/Oncology Pediatric Cardiology Pediatric Critical Care Float Pool Pediatric ER Pediatric MICU Pediatric PCU Pediatric Stepdown Pediatric Telemetry PICU SICU Stepdown Stepdown Cardiac Stepdown Neuro Tele Float Telemetry Trauma ICU  Modules:Modules are billable up to 4 hours, any additional time beyond this is non-billable and must be margined. The average module duration is 12 hours.Modules are completed pre-start and potentially during orientation, and can vary by specialtyModules are recorded via transcripts Guaranteed Hours: Contract Weeks:91