Strategic Staffing Solutions Detroit, MI , Wayne County, MI
Posted 3 days ago
STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING Strategic Staffing Solutions is currently looking for Post-Acute Care RN’s for a contract opportunity with one of our largest clients located in Detroit, MI Title: Post-Acute Care RN - multiple openings Location:
Detroit, MI Duration: 12 Months Role Type: W2 contract engagement ROLE SUMMARY UM - Utilization Management • Medicare Advantage Post-Acute Care RN: • Use established medical policy and guidelines to perform prospective, concurrent, and retrospective medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length of stay, including appeal requests initiated by providers, facilities and members. • Will coordinate care through the health care continuum including member outreach. • Provides support and alternative care support for member not appropriate for post-acute care service as well formulate discharge readiness for members transitioning from a post-acute care setting to a lower level of care. Requirements: • Bachelor’s degree in nursing, allied health, business, or related field preferred. • Two (2) to four (4) years of clinical experience which may include post-acute care, home care, acute patient care, discharge planning, case management, and utilization review, and caring for aging population in the home or post-acute care setting, etc. • Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes. • One (1) year health insurance plan experience or managed care environment preferred. • Registered Nurse with current unrestricted Michigan Registered Nurse license required. The following skills are not required, but may be preferred depending on assignment: • Understanding Medicare Requirements for skilled vs non-skilled services in post-acute care and home setting • Certification in Case Management • Experience with management of patients with compromised airways requiring skilled services • Experience with goals planning and intervention for patients recovering after unplanned or prolonged hospital admission including but not limited to stroke, hip and femur fractures with surgical intervention after a fall, sepsis, ventilator dependency, sever change in functional ability.
Strategic Staffing Solutions