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The skills checklist, required by hospital hiring managers, is an important tool we use to help match you to an ideal assignment. This self-assessment form gives us an overview of your nursing experience and proficiencies so our recruiters are better able to find the positions that suit you. Select the appropriate checklist below and submit your completed form to us with one simple click. If your specialty is not listed below, or if you need additional information or assistance, please contact your local O'Grady Peyton International representative.

Return to the full Skills Checklist page
 

Case Management/Utilization Review Skills Checklist

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This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Passport.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
(Country Code - Area Code - Local)
 
1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
 
GENERAL CASE MANAGEMENT SKILLS OVERVIEW EXPERIENCE
1 2 3 4
 
Discharge Planning
 
Utilization review (assess completion and accuracy of patient records after treatment occurred)
 
Utilization management (develop plans/procedures to help improve outcome of reviews)
 
InterQual criteria
 
Milliman criteria (MCG)
 
Indicia hospital performance index (powered by MCG)
 
ICD-10 coding knowledge (in relation to charting & reimbursements)
 
Understanding of patient status assessments & medical necessity of patient admission and/or continued stay
 
Developing appropriate strategies & solutions to reduce LOS (length of stay)
 
REGULATING AGENCIES & STANDARD POLICIES EXPERIENCE
1 2 3 4
 
Centers for Medicare & Medicaid Services (CMS)
 
Health Insurance Portability & Accountability Act (HIPAA)
 
Value Based Purchasing programs (created by CMS)
 
Patient protection and Affordable Care Act (ACA) (a.k.a. ObamaCare)
 
Two midnight rule
 
Condition 44 (Code 44)
 
Medicare Outpatient Observation Notice (MOON)
 
IMM (Important Message from Medicare letter)
 
PASRR (preadmission screening and resident review)
 
INPATIENT BASED SKILLS EXPERIENCE
1 2 3 4
 
Universal precautions
 
National Patient Safety Goals
 
Cardiac arrest / CPR
 
Use of Rapid Response Teams
 
BLS certification (basic life support)
 
DISCHARGE PLANNING EXPERIENCE
1 2 3 4
 
Identification of immediate, short-term, & ongoing needs
 
High acuity / complex case discharge planning
 
Arranging DME
 
Organizing referrals & transfers
 
Direct patient / family counseling & education
 
EVALUATION & UTILIZATION REVIEW EXPERIENCE
1 2 3 4
 
Prior authorization review (pre-certification)
 
Continued stay reviews (concurrent)
 
Retrospective utilization review
 
Understanding of diagnosis related groups (DRGs)
 
Recovery audit contractor review and denials (RAC audits)
 
Appeals & denial management
 
ASSESSMENT & DAILY PRACTICE EXPERIENCE
1 2 3 4
 
Pt. status assessment / medical necessity of admission
 
Analyzing past/present treatment course
 
Treatment & provider options
 
Collaboration members of the healthcare team / daily rounding
 
Knowledge & application of commercial payers & processes
 
Knowledge & application of Medicare payment processes (elderly & disabled)
 
Knowledge & application of Medicaid payment processes (low income)
 
Knowledge & application of processes for dual eligible (Medicaid & Medicare eligible patients under ACA)
 
EHR/EMR/CHARTING SOFTWARE EXPERIENCE
1 2 3 4
 
Cerner Power Chart
 
Epic
 
Midas (a.k.a. juvo)
 
Allscripts
 
Meditech
 
eClinicalWorks
 
McKesson Review Manager (a.k.a. CERMe)
 
ARCIS
 
Curaspan (a.k.a. naviHealth referral management system)
 
Morrisey
 
Sorian
 
MedHost
 
MorCare
 
Xolis (payer connected UM technology)
 
Ensocare
 
HealthConnect (Kaiser proprietary system)
 
NextGen
 
SilverVue
 
Ibex
 
Kepro
 
Kronos (timekeeping system)
 
ShiftWise (timekeeping system)
 
Microsoft Office Suite (including outlook email & teams)
 
Please add additional software competencies not listed above here:
 
WORK SETTINGS EXPERIENCE
1 2 3 4
 
Short term acute care hospital (short term stay/inpatient setting)
 
Dyad model case mgmt. department (blended CM & social work dept.)
 
Triad model case mgmt. departments (separate UR, CM & social work)
 
Teaching Hospital / Academic Hospital
 
Level 1 Trauma Center
 
Long term acute care hospital (LTAC)
 
Pediatric / Children’S Hospital
 
Skilled Nursing Facility (SNF)
 
Psychiatric / Behavioral Health Facility
 
Remote/work from home (case management)
 
Home Health
 
Hospice / Palliative Care
 
AGE APPROPRIATE CARE EXPERIENCE
1 2 3 4
 
Newborn & infant (birth – 1 year)
 
Pediatrics & young adults (1 – 17 years)
 
Adults (18 – 65 years)
 
Geriatric (65+ years)
 
PLEASE MARK ALL APPLICABLE FLOOR RN UNITS OF COVERAGE EXPERIENCE
 
Admission
 
Ambulatory
 
Cardiac
 
Cardiothoracic
 
CCU or CICU (cardiac/coronary)
 
Covid-19
 
Emergency Room
 
Gender Reassignment
 
General floor/med-surg
 
ICU or CCU (intensive/critical care)
 
Labor-delivery / post-partum / maternity
 
Medical
 
MICU (medical ICU)
 
Neuro advanced care unit (NACU)
 
NICU (Neonatal ICU)
 
Observation
 
Oncology
 
Ortho/neuro
 
PACU (post-anesthesia care)
 
Palliative/Hospice
 
Pediatric
 
PICU (Pediatric ICU)
 
Psychiatric
 
Renal
 
Rheumatology
 
SICU (surgical ICU)
 
Step down/transitional
 
Surgical
 
Telemetry
 
TICU (trauma ICU)
 
Transplant
 
Urology
 
PLEASE MARK ALL APPLICABLE RN CASE MANAGEMENT UNITS OF COVERAGE EXPERIENCE
 
Admission
 
Ambulatory
 
Cardiac
 
Cardiothoracic
 
CCU or CICU (cardiac/coronary)
 
Covid-19
 
Emergency Room
 
Gender Reassignment
 
General floor/med-surg
 
ICU or CCU (intensive/critical care)
 
Labor-delivery / post-partum / maternity
 
Medical
 
MICU (medical ICU)
 
Neuro advanced care unit (NACU)
 
NICU (Neonatal ICU)
 
Observation
 
Oncology
 
Ortho/neuro
 
PACU (post-anesthesia care)
 
Palliative/Hospice
 
Pediatric
 
PICU (Pediatric ICU)
 
Psychiatric
 
Renal
 
Rheumatology
 
SICU (surgical ICU)
 
Step down/transitional
 
Surgical
 
Telemetry
 
TICU (trauma ICU)
 
Transplant
 
Urology
Case Management/Utilization Review Skills Checklist, version 8

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided will result in being ineligible to work with AMN Healthcare. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.
O'Grady Peyton International staffs nursing jobs for individuals wanting to work in the United States. We staff travel nurses domestically and fill long-term nursing and allied health assignments for international providers.
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