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REGISTERED NURSE CASE
MANAGER CHECKLIST
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NAME
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LAST 4 OF SSN
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DATE
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I hereby certify that
ALL information I have provided to IMCS Group on this skills checklist and
all other documentation, is true and accurate. I understand and acknowledge
that any misrepresentation or omission may result in disqualification from
employment and/or immediate termination.
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Instructions: This checklist is
meant to serve as a general guideline for our client facilities as to the
level of your skills within your nursing specialty. Please use the scale
below to describe your experience/expertise in each area listed below.
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Proficiency Scale:
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1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
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Rating Stars (Click)
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KNOWLEDGE, SKILLS,
ABILITIES
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1
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2
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3
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4
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Knowledge of community
health care and vocational services
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Ability to properly
maintain records
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Knowledge of medical
billing procedures
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Strong interpersonal and
communication skills and the ability to work effectively in all situations
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Ability to monitor, assess
and record client progress against care plan and make adjustments
accordingly.
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Ability to assess mental
status in clients and to develop individual treatment goals and plans
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Ability to plan, implement
and evaluate individual patient care programs
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Ability to gather data,
compile information and prepare reports
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Ensure outcomes are met
within an appropriate length of stay
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Coordinate and monitors
services, including comprehensive tracking of client activities in relation
to care plan
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Assist clients in
developing goals and areas of need, and assists in developing treatment plans
which are assessed regularly
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Conduct medication and
mental status assessment and determines required level and frequency of
service
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Document all client
encounters and contracts made on behalf of clients
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Complete and submit
billing documentation as appropriate
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Maintain comprehensive
client files, which may include documents held for safekeeping on behalf of
client
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Identify and provide
emergency crisis services as necessary
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Make immediate clinical
assessments and respond according to accepted crisis intervention methods and
techniques
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Coordinates other services
as appropriate
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Assess patients, evaluate
effectiveness of care plan and progress made by client
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Participate in patient
treatment planning and case review with patient care providers
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Ability to develop and
implement action plans for health centers to improve performance.
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Rating Stars
(Click)
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EXPERIENCE
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1
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2
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3
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4
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Concurrent Review
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Utilization Review
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Utilization Management
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Prior Authorization
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Disease Focused Case
Management
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Catastrophic Case
Management
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Home Health
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Work Comp
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Rating Stars
(Click)
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COMPUTER SKILLS
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1
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2
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3
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4
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Job Related Computer
Knowledge
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Interqual - McKesson
software familiarity
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Rating Stars
(Click)
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EMR
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1
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2
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3
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4
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Epic
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Cerner
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Eclipsys
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McKesson
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Meditech
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Other Computerized System
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Computerized Physician
Order Entry
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Bar Coding for Medication
Administration
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MY EXPERIENCE IS
PRIMARILY IN:
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Unit
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No. of Years
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Unit
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No. of Years
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BURN
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POST PARTUM
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CRITICAL UNIT
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LABOR & DELIVERY
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PACU
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NEWBORN NURSERY
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NEUROLOGY
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LEVEL II NICU
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TELEMETRY
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LEVEL III NICU
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MEDICAL
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PICU
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SURGICAL
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PEDIATRICS
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ONCOLOGY
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OB/GYN
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ORTHOPEDICS
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PSYCHIATRY
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OPERATING ROOM
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RRT
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EMERGENCY ROOM
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CRT
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TRAUMA CENTER
LEVEL 1
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COMMUNITY ER
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RURAL ER
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Rating Stars
(Click)
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Age Specific Competencies
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1
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2
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3
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4
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Newborn/Neonatal (birth –
30 days)
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Infant (30 days-1 year)
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Toddler (1-3 years)
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Preschool (3-5 years)
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School Age Children (5-12
years)
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Adolescent (12-17 years)
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Young Adults (18-44 years)
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Middle Adults (45-64
years)
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Older Adults (>65
years)
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