Skill Checklists

Case Management Utilization

This checklist was electronically signed on (Today’s date)

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.

Proficiency Scale:

  • 1 = No Experience

  • 2 = Need Training

  • 3 = Able to perform with supervision

  • 4 = Able to perform independently

Setting

Acute Care

Skilled/LTAC

MDS Coordinator

Home Health

Telephonic

Workers Compensation

Insurance

Managed Care

Acute Rehab

CM/UR Software

Interqual

Milliman

MIDAS

Allscripts UR

Word Processing Software

Other: Specify

Regulatory

CMS/Medicare

HEDIS Measures

Core Measures

Medicaid/Medical

DRG

ICD 9 Coding

ICD 10 Coding

CPT

Process

Benefits Eligibility

Pre-Certification Review

Review for Admission Criteria

Identify Appropriate Level of Care

Review Status During Stay

Discharge Planning

Physician Advisor

Clinical Documentation Improvement

Needs Assessment/Order DME

Needs Assessment/Home Health

Needs Assessment/Skilled

Third Party Authorization Process

Concurrent Review

Retrospective Review

Professional Knowledge and Skills

National Patient Safety Goals

Age Specific/Population Based Care

Age Specific Competencies

Infant (Birth - 1 year)

Preschooler (ages 2-5 years)

Childhood (ages 6-12 years)

Adolescents (ages 13-21 years)

Young Adults (ages 22-39 years)

Adults (ages 40-64 years)

Older Adults (ages 65-79 years)

Elderly (Ages 80+ years)

EMR

Epic

Cerner

Eclipsys

McKesson

Meditech

Allscripts

EMR Conversion

Other: Specify

Certifications

BLS

Certified Case Manager (CCM)

Accredited Case Manager (ACM)

Certified Disability Management Specialist (CDMS)

Certified Clinical Documentation Specialist (CDMS)

ACLS

Other: Please note any ICD 10 training

I hereby certify that ALL information I have provided 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.