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Skills Checklists

Before you can begin applying for NurseChoice assignments, you need to complete a skills checklist. Required by hospitals, this mandatory form highlights your skills, proficiencies and experience in your specialty. The quickest and easiest way to complete your skills checklist is online. Just select your specialty from the list below, enter the necessary information on the form and click to submit. Once we receive your completed skills checklist you will be one step closer to finding a rewarding travel assignment that meets your needs.


Case Management/Utilization Review Skills Checklist

*
Denotes required field

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 Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
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
 
SETTING
1 2 3 4
 
Acute Care
 
Acute Rehab
 
Home Health
 
Insurance
 
Managed Care
 
MDS Coordinator
 
Skilled/LTAC
 
Telephonic
 
Workers Compensation
 
CM/UR SOFTWARE
1 2 3 4
 
Allscripts UR
 
Interqual
 
MIDAS
 
Milliman
 
Word Processing Software
 
Other: Specify
 
Other: Specify
 
REGULATORY
1 2 3 4
 
CMS/Medicare
 
Core Measures
 
CPT Codes
 
DRG
 
HEDIS Measures
 
ICD 10 Coding
 
ICD 9 Coding
 
Medicaid/Medical
 
PROCESSES
1 2 3 4
 
Benefits Eligibility
 
Clinical Documentation Improvement
 
Concurrent Review
 
Discharge Planning
 
Identify Appropriate Level of Care
 
Needs Assessment (Setting Specific)
 
Physician Advisor
 
Pre-Certification Review
 
Retrospective Review
 
Review for Admission Criteria
 
Review Status During Stay
 
Third Party Authorization Process
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
National Patient Safety Goals
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age Children
 
Adolescents
 
Young/Middle Adults
 
Older Adults/ Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computer Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS (Current at the time this form is completed)
 
BLS
 
Certified Case Manager (CCM)
 
Certified Clinical Documentation Specialist (CDMS)
 
Certified Disability Management Specialist (CDMS)
 
PHN (Public Health Nurse)Certification (this is asked on the VI)
 
Other: Please note any ICD 10 training
 
Other: Specify
 
Other: Specify
Case Management/Utilization Review Skills Checklist, version 5

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 travel with AMN. 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.

© 2013 AMN Healthcare, Inc. All rights reserved. Reproduction and distribution of these materials is prohibited without the expressed written authorization of AMN Healthcare, Inc.