Travel Nurse RN - Utilization Review
Charlotte, NC
Talent4Health
5x8 hrs, Days

• Shift: Day 5x8-Hour (08:30 - 17:00)

• Block Schedules: No

  Years of Experience: 3 year(s)

• Note: Current w/i the last 3 years MDS experience required. Actually, completing assessments and not management role
• Patient Ratio Experience: 1:12
• Charting System: Required, Epic
  Certfications:Certs marked with * are preferred - BLS, ICD-10*, RAC-CT*

***BSN REQUIRED WITH 3 YEARS OF EXPERIENCE***

REQUIRED SKILLS / CERTS / EXP:
Minimum Years of Experience: 3 Years Minimum REQUIRED - ***Current within the last 3 years MDS experience required. Actually, completing assessments and not a management role***
Traveler Experience: Unit WILL ACCEPT 1st Time Travelers
Locals Accepted / Rate Difference: Yes
***Work Settings Skills REQUIRED: Long Term Acute Care/Skilled Nursing, Managed Care, MDS Coordinator & Rehab
*** Processes Skills REQUIRED: Admission Criteria, Appeals and Denials, Audits, Benefits Eligibility, Care coordination, Clinical Documentation Improvemen, Determine Medical Necessity per Evidence-Based Guidelines, Discharge Planning, Needs Assessment/ Order DME, Needs Assessment/Home Health, Needs Assessment/Hospice, Needs Assessment/Skilled Nursing, Physician Advisor, Plan of Care, Pre-Cert Review, Prior Authorizations, QI/ CASPER Review & Retrospective Review
***Regulatory Skills REQUIRED: CMS: Centers for Medicare and Medicaid Services, CPT (Current Procedural Terminology) coding and billing, Department of Health, ICD 10 Coding & MDS
***Professional Topics and Skills REQUIRED: Age Specific/Population Based Care
***Additional Skills REQUIRED: Triple Check/ Utilization review
***NC STATE LICENSE REQUIRED***
Certs: BLS

***Current within the last 3 years MDS experience required. Actually, completing assessments and not a management role***

***BSN REQUIRED WITH 3 YEARS OF EXPERIENCE***

PREFERRED SKILLS / CERTS / EXP:
-Regulatory Skills: DRG (Diagnosis Related Groups), HIPAA guidelines (Health Insurance Portability and Accountability Act), NCQA (National Committee for Quality Assurance), OBRA (Omnibus Budget Reconciliation Act) & RAPS( Risk Adjustment Processing Systems)
-Professional Topics and Skills: Educate/Provide resources regarding nursing duties to floor staff
-LTAC Experience
Certs: RAC-CT, ICD-10

JOB DETAILS:
-RATIOS: 1:12; Avg. Daily Census: 9; Rooms/Beds: 12
-SHIFT: *40 Hours Can Be Offered
-Will Accept 13 Weeks.
-8-HOUR DAYS; 08:30 - 17:00
-Call Requirement: NONE
-Float Requirement: NONE
-Weekend Requirement: NONE

PATIENT DIAGNOSES: Dx range from generalized weakness to surgical aftercare. The unit gets a wide variety of dx with a large portion being after care for surgery and surgical wounds/ pressure ulcers.

SPECIAL PROCEDURES / UNIT DETAILS: Unit is a Skilled Nursing Facility within the hospital. Accepting residents in need of short-term rehab for 14-21 days. The unit provides round-the-clock nursing and medical support, as well as PT/OT and ST as required for the resident per evaluation.
-MDS is an integral part of the unit and is responsible for MDS completion, baseline care plan completion and presentation to residents, care plan meeting, carpe plan development and CAA completion, submission and validation of assessments, oversite of cert/recert process, properly dx code for new admissions, education MDS changes and triple check/ utilization review ensuring UB04 is properly completed and validated for release.
-Other duties are admission referral review and preauthorization of insurance for new admissions as needed to back up SW.

SPECIAL EQUIPMENT: The unit does not utilize restraints

UNIT SYSTEMS: Pyxis, EPIC & EPIC chat/ Voalte and Rover

SCHEDULING TYPE: Per Unit Needs

UNIT ORIENTATION: 24 Hours in the unit after Week One Hospital Orientation

SCRUBS: Not Provided. Navy Blue

INTERVIEW AVAILABILITY: *****Please provide your candidate's interview availability for the next 72 hours while submitting candidates to avoid holding up the approval process. Manager WILL NOT OFFER without speaking to/interviewing the candidate first*****