Job Description

Bestica is seeking a travel nurse RN Case Management for a travel nursing job in Edmonds, Washington.

Job Description & Requirements

• Specialty: Case Management
• Discipline: RN
• Start Date: 09/08/2025
• Duration: 13 weeks
• 40 hours per week
• Shift: 8 hours, days
• Employment Type: Travel

2978775 

 

Years of Experience:

1 year(s)

Note: Supported Units Experience - REQUIRED: Med Surg; PREFERRED: ED, ICU, NICU, L&D/Mother-Baby

 

Open to MSW Care Manager (& have EITHER Associate clinical license or LCISW) or RN Care Manager. Requires a 1) Masters in social work and 2)Washington-issued post-MSW license such as the licensed social work associate independent clinical. (The associate licenses are the precursor to the “full” social work licenses.) Please confirm with submission clinician has the required docs.

Must have case management and discharge experience. Utilization management experience is helpful but not required.

 

 

General Skills Exp:

Acute Hospital, Patients with Communication Prob (Hearing/Speech), Community Programs (Income/Insurance), Community Based Service Programs, APS (REQUIRED)

Advance Directives, Americans with Disabilities Act, High Risk Intervention Patient Vulnerability or Safety Risk, Knowledge of Cultural Issues, NASW Code of Ethics/Standards of Home Health Care, CPS, Emergency Detention, Adopt/Foster Care, Suicide/Homicide/Self-Harm (PREFERRED)

Case Management/Assessment Exp:

Admission Criteria, Conduct Initial Eval, Develop Plan of Care/Care coordination, Discharge Planning, Utilize InterQual Criteria, Utilize Milliman Guidelines, Appeals and Denials, Concurrent Review, Continued Stay Reviews, Medical Necessity, Retrospective Review, (REQUIRED)

Assess Response to Treatment, Biopsychosocial Assessment, Geriatric Depression Scale, Mini-Mental State Examination (PREFERRED)

Care Coord Exp:

Coordinate Services - Home Care, Document Info to Facilitate Care Coord, Participates in Care Conference Activities, Referrals to Rehab and LTC Facilities, Refers to Other Disciplines/Resources (REQUIRED)

Documentation/Communication Exp:

Documentation According to Plan of Care, Documentation of Care Delivery/Plan/Goals/etc, Documentation Reflects Understanding of Coverage Criteria (REQUIRED)

PREFERRED: Discharge Summary, Documentation of Patient/Caregiver Teaching/Learning

Major Disease Processes Exp:

Dementia, Stroke (REQUIRED)

Cancer, CHF, COPD, Diabetes, HIV/AIDS, Immune Deficiency, Neurological Disorders, Paralysis, Psychiatric Disorders (PREFERRED)

REGULATORY (REQUIRED):
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 (The 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

CHARTING (REQUIRED):
Epic, Cerner

CERTS: BCLS required
SKILLS: Med Surg Acute Care Required
FLOAT: yes, Case manager responsibilities include care coordination, and discharge planning

 

Skills: Skills marked with * are preferred

Work Settings

Acute Hospital

Case Management/Utilization Review

Admission Criteria

Care coordination

Discharge Planning

Utilize InterQual Criteria

Utilize Milliman Guidelines

Utilization Review

Admission Criteria

Appeals and Denials

Concurrent Review

Continued Stay Reviews

Medical Necessity

Retrospective Review

Utilize InterQual Criteria

Utilize Milliman Guidelines

Regulatory

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 (The 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

Acute Hospital Experience by Specialty

MS

Additional Skills

See Text Box for additional requirements

2978775 Years of Experience: 1 year(s) Note: Supported Units Experience - REQUIRED: Med Surg; PREFERRED: ED, ICU, NICU, L&D/Mother-Baby Open to MSW Care Manager (& have EITHER Associate clinical license or LCISW) or RN Care Manager. Requires a 1) Masters in social work and 2)Washington-issued post-MSW license such as the licensed social work associate independent clinical. (The associate licenses are the precursor to the “full” social work licenses.) Please confirm with submission clinician has the required docs. Must have case management and discharge experience. Utilization management experience is helpful but not required. General Skills Exp: Acute Hospital, Patients with Communication Prob (Hearing/Speech), Community Programs (Income/Insurance), Community Based Service Programs, APS (REQUIRED) Advance Directives, Americans with Disabilities Act, High Risk Intervention Patient Vulnerability or Safety Risk, Knowledge of Cultural Issues, NASW Code of Ethics/Standards of Home Health Care, CPS, Emergency Detention, Adopt/Foster Care, Suicide/Homicide/Self-Harm (PREFERRED) Case Management/Assessment Exp: Admission Criteria, Conduct Initial Eval, Develop Plan of Care/Care coordination, Discharge Planning, Utilize InterQual Criteria, Utilize Milliman Guidelines, Appeals and Denials, Concurrent Review, Continued Stay Reviews, Medical Necessity, Retrospective Review, (REQUIRED) Assess Response to Treatment, Biopsychosocial Assessment, Geriatric Depression Scale, Mini-Mental State Examination (PREFERRED) Care Coord Exp: Coordinate Services - Home Care, Document Info to Facilitate Care Coord, Participates in Care Conference Activities, Referrals to Rehab and LTC Facilities, Refers to Other Disciplines/Resources (REQUIRED) Documentation/Communication Exp: Documentation According to Plan of Care, Documentation of Care Delivery/Plan/Goals/etc, Documentation Reflects Understanding of Coverage Criteria (REQUIRED) PREFERRED: Discharge Summary, Documentation of Patient/Caregiver Teaching/Learning Major Disease Processes Exp: Dementia, Stroke (REQUIRED) Cancer, CHF, COPD, Diabetes, HIV/AIDS, Immune Deficiency, Neurological Disorders, Paralysis, Psychiatric Disorders (PREFERRED) REGULATORY (REQUIRED): 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 (The 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 CHARTING (REQUIRED): Epic, Cerner CERTS: BCLS required SKILLS: Med Surg Acute Care Required FLOAT: yes, Case manager responsibilities include care coordination, and discharge planning Skills:Skills marked with * are preferred Work Settings Acute Hospital Case Management/Utilization Review Admission Criteria Care coordination Discharge Planning Utilize InterQual Criteria Utilize Milliman Guidelines Utilization Review Admission Criteria Appeals and Denials Concurrent Review Continued Stay Reviews Medical Necessity Retrospective Review Utilize InterQual Criteria Utilize Milliman Guidelines Regulatory 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 (The 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 Acute Hospital Experience by Specialty MS Additional Skills See Text Box for additional requirements

About Bestica

We are a trusted provider of solutions in Information Technology and Healthcare sectors to the DoD, Federal and Commercial markets. Our guiding principle and core values help us care for our people and the community; and build a culture of excellence which in turn helps us achieve our organizational objective of exceeding customer’s expectations in each and every project. Headquartered in San Antonio, TX, we were founded in 2005 and are certified as an 8(a) Business.

Job Tags

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