Registered Nurse

Join Our Team as a Registered Nurse – Case Management RN in Anchorage, AK

Are you a dedicated and experienced Registered Nurse looking to make a meaningful impact in case management? We are seeking a qualified professional to join our team through Quick2Hire staffing agency, where you will have a dedicated recruiter to support you and enjoy the benefit of weekly pay. This is an excellent opportunity to apply your clinical expertise in a dynamic, acute hospital setting while leveraging your skills in utilization review and care coordination.

Shift & Schedule

• Day Shift
• Five 8-hour shifts per week
• Shift Hours: 7:30 AM – 4:00 PM

Requirements & Skills

• At least 2 years of nursing experience
• Proficient in Epic charting system (required)
• ACM-RN certification (required)
• AK RN license in good standing
• BLS certification (required)
• Preferred experience working in a Community Hospital
• Preferred experience in LTAC (Long-Term Acute Care)
• Preferred Trauma Level II experience
• Acute hospital experience, specifically in Emergency Department, NICU, Pediatrics, PICU, and Women’s Services (all required)
• Proven skills in Case Management and Utilization Review including:
  • Admission Criteria (required)
  • Care coordination
  • Continued Stay Reviews
  • Determining Medical Necessity per Evidence-Based Guidelines
  • Needs Assessment and Ordering Durable Medical Equipment (DME)
  • Plan of Care development
  • Pre-Certification Review (required)
  • Prior Authorization processes (required)
  • Utilization of InterQual Criteria (required)
  • Utilization of Milliman Guidelines (required)
  • Worker’s compensation case management (required)
• Strong understanding of regulatory compliance including:
  • CMS – Centers for Medicare and Medicaid Services
  • Department of Health regulations (required)
  • HIPAA guidelines
  • ICD 10 coding (required)
  • The Joint Commission/Core Measures/National Safety Goals (required)
  • Workers Compensation regulations (required)

Key Responsibilities

• Conduct admission and continued stay reviews ensuring compliance with hospital and regulatory standards.
• Coordinate patient care across multidisciplinary teams, ensuring smooth transitions and appropriate utilization of resources.
• Perform comprehensive needs assessments and order necessary durable medical equipment.
• Apply evidence-based guidelines and InterQual and Milliman criteria to determine medical necessity and support prior authorization processes.
• Maintain accurate and timely documentation using the Epic charting system in compliance with regulatory guidelines and organizational policies.
• Collaborate with payer representatives to facilitate pre-certifications and appeal processes.
• Manage workers’ compensation case assignments adhering to established protocols and guidelines.
• Ensure all care plans meet Joint Commission standards and contribute to quality improvement initiatives.
• Adhere to HIPAA and Department of Health regulations to protect patient privacy and confidentiality.

Qualifications

• Current and valid Registered Nurse license in Alaska
• ACM-RN certification is mandatory
• Minimum 2 years of clinical nursing experience with demonstrated case management skills
• Proficiency in Epic electronic health record system
• Certified in Basic Life Support (BLS)
• Experience within acute hospital settings, preferably with exposure to Emergency, NICU, Pediatrics, PICU, and Women’s Services
• Strong knowledge of Medicare, Medicaid, ICD-10 coding, and utilization management guidelines
• Excellent communication, organizational, and analytical skills
• Ability to work independently and as part of a collaborative healthcare team

Compensation

Competitive hourly rate ranging from $64.00 to $76.00 based on experience and qualifications.

This opportunity is offered through Quick2Hire staffing agency, providing you with a dedicated recruiter to assist you throughout your assignment and the convenience of weekly pay.

This healthcare facility is a cornerstone of medical excellence in the region, offering a comprehensive range of services designed to meet the diverse needs of the community. With a focus on patient-centered care, the facility provides primary care, urgent care, and specialized services such as cardiopulmonary testing, diagnostic imaging, and a state-of-the-art birthing center. The facility's commitment to compassionate care is evident in its extensive behavioral health and chemical dependency programs, ensuring holistic support for patients. Additionally, the presence of the Otto Klein Cancer Center and a robust orthopedics department highlights its dedication to specialized and advanced medical treatments.

Located in the picturesque town of Polson, MT, the facility serves a vibrant community nestled along the shores of Flathead Lake. This location offers healthcare professionals the unique opportunity to work in a serene environment that balances professional growth with quality of life. The facility is part of a not-for-profit Catholic health care ministry, emphasizing its mission to provide accessible, high-quality care while fostering a supportive and inclusive work culture. With a commitment to innovation and community well-being, this healthcare facility is an ideal place for professionals seeking to make a meaningful impact while enjoying the natural beauty and recreational opportunities of Montana.