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Hudson Staffing Travel Nurses| Case Management/Utilization Review Online Checklist
Case Management/Utilization Review Online Checklist
Thank you for your decision to apply for a travel nursing position with
! Before we can offer you a nursing employment opportunity in the Case Management/Utilization Review field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.
Denotes a required field.
Please enter your full name as it appears on your Social Security Card:
Please enter the Last Four digits of your Social Security Number:
Please check here if you do not hold a valid social security card.
Please provide your contact information:
Confirm E-mail Address
Type your e-mail address again above.
This profile is for use by healthcare professionals in the Case Management/Utilization Review discipline and specialty.
It will not be a determining factor for the program.
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
Word Processing Software
Review for Admission Criteria
Identify Appropriate Level of Care
Review Status During Stay
Needs Assessment/Order DME
Needs Assessment/Home Health
Third Party Authorization Process
PROFESSIONAL KNOWLEDGE AND SKILLS
National Patient Safety Goals
Age Specific/Population Based Care
EMR Conversion y/n
Certified Case Manager (CCM)
Accredited Case Manager (ACM)
Certified Disability Management Specialist (CDMS)
Please read and agree to the statements below by marking the checkbox.
You will not be able to submit until you have marked the checkbox.
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. I hereby authorize Hudson Staffing to release this Case Management/Utilization Review Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.
Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (188.8.131.52) which will be used as a digital signature.
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