RN Case Manager Skills Checklist The following checklist is a profile used to assess your RN Case Manager proficiency and assist in matching your skills with available assignments. Your employment is not dependent upon responses given on this checklist. Please rate your ability as accurately as possible by checking the appropriate option. Step 1 of 4 25% Name* First Middle Last PLEASE MARK YOUR LEVEL OF EXPERIENCE 0 - No Experience 1 - Theory/Observed Only 2 - Intermittent Experience 3 - Moderate Experience 4 - ExpertSettingAcute Care01234Skilled/LTAC01234MDS Coordinator01234Home Health01234Telephonic01234Workers Compensation01234Insurance01234Managed Care01234Acute Rehab01234CM/UR SoftwareInterqual01234Milliman01234MIDAS01234Allscripts UR01234Word Processing Software01234Other: SpecifyUse the button on the right to add more rows.TypeLevel of Experience (0-4) RegulatoryCMS/Medicare01234HEDIS Measures01234Core Measures01234Medicaid/Medical01234DRG01234ICD 9 Coding01234ICD 10 Coding01234CPT01234ProcessesBenefits Eligibility01234Pre-Certification Review01234Review for Admission Criteria01234Identify Appropriate Level of Care01234Review Status During Stay01234Discharge Planning01234Physician Advisor01234Clinical Documentation Improvement01234Needs Assessment/Order DME01234Needs Assessment/Home Health01234Needs Assessment/Hospice01234Needs Assessment/Skilled01234Third Party Authorization Process01234Concurrent Review01234Retrospective Review01234 Professional Knowledge and SkillsNational Patient Safety Goals01234Age Specific/Population Based Care01234EMREpic01234Cerner01234Eclipsys01234McKesson01234Meditech01234Allscripts01234Other: SpecifyUse the button on the right to add more rows.TypeLevel of Experience (0-4) EMR ConversionYesNo CertificationsBLS Yes No Expiration Date Date Format: MM slash DD slash YYYY Certified Case Manager (CCM) Yes No Expiration Date Date Format: MM slash DD slash YYYY Accredited Case Manager (ACM) Yes No Expiration Date Date Format: MM slash DD slash YYYY Certified Disability Management Specialist (CDMS) Yes No Expiration Date Date Format: MM slash DD slash YYYY Certified Clinical Documentation Specialist (CCDS) Yes No Expiration Date Date Format: MM slash DD slash YYYY ACLS Yes No Expiration Date Date Format: MM slash DD slash YYYY Other: Please note any ICD 10 trainingUse the button on the right to add more rows.TypeExpiration Date Other CertificationsUse the button on the right to add more rows.TypeExpiration Date AcceptanceThe information I have given is true and accurate to the best of my knowledge. In addition, I hereby authorize Medestar to release this RN Case Manager profile to client institutions of Medestar in consideration of my employment with that institution.SignatureSign using your mouse or finger (if on a mobile or tablet device) to draw your signature.