Nextcase

Latest Activity

1. Telework & Multi-state License

   Nextcase replied to Nextcase's topic in Case Management

   GrnTea that is the point Exactly the employers should be aware so if they are not telling their employees this fact are we to assume they are willfully skirting the law? What agency would have oversight over the employer following this law and not pu...

2. Pt's home infested with bed bugs, fleas, etc..

   Nextcase replied to RN-DC's topic in Home Health

   Check with your state BON. If you feel you can't give safe and effective care then you can refuse any assignment. In addition you may very well have a duty legally to report neglect and abuse. He lives with others and this situation could very well f...

3. Telework & Multi-state License

   Nextcase replied to Nextcase's topic in Case Management

   Thank you elpark i appreciate you condensing the facts surrounding my question. I want to know though how many CMs are working across states lines that did not know or were not told by their employer they need additional licenses. So telework nur...

4. Telework & Multi-state License

   Nextcase posted a topic in Case Management

   I am interested to know if nurses working from home are informed by their employer they need additional licensure for out of state cases under certain circumstances? Did your employer pay for getting or renewing all licenses? My curiosity has been ar...

5. *Pay at Aetna- Details on job*

   Nextcase replied to missymis86's topic in Case Management

   I tried to answer you private msg. Typed a big long reply and when I hit send it said I was not allowed to send private messages..sigh and deleted it...sigh. Any way learn the WC reg inside and out, and work well with the adjuster. I LOVE the fact...

6. Utilization Review Certification?

   Nextcase replied to MMills30's topic in Case Management

   You can telecommute with Aetna and do UR, I believe they still require you to start in office. AHH (owned by Aetna) will start you at home right away after training in Ohio. Many of the UR nurses moved to that from the CM side. Some are CCM and othe...

7. For nurses who work from home

   Nextcase replied to luvsfallin's topic in Case Management

   Mmlils30, I know of some CM doing 10 hr shifts at AHH and Meritain which are part of Aetna. Reality is that since it is salaried position many scheduled to work 8 hrs are working 12-14 days and some weekends. Case load is 50% higher than what is ...

8. Need Help - Offered Workers' Comp Field Nurse Case Manager Position

   Nextcase replied to MiahMSN's topic in Case Management

   I did worker's compensation cm for 5 years. I am now in another speciality. In some ways it was better because the adjuster has a lot of control over the decision to pay for something. I had an adjuster agree to pay for a surgey the medical reviewe...

9. *Pay at Aetna- Details on job*

   Nextcase replied to missymis86's topic in Case Management

   Stand your ground on not taking a pay cut. They generally use an outside recruiter and they lowball everybody and say they will not negotiate.... Good luck!

10. Utilization management question

    Nextcase replied to mayakovsky's topic in Case Management

    @been there.... Perhaps "stuff" was not a word choice to your liking? How about I phrase it as finding the appropriate criteria based on the clinical documentation supplied by the physician or facility? I do complex CM and I do my own UR on the pat...

11. Utilization management question

    Nextcase replied to mayakovsky's topic in Case Management

    I would say the interqual had a short learning curve of less than a month because it was basically check a box and get a green or red light. Milliman took a good 6 months to really be able to find stuff fast and write the rational.

12. New job as a Case Manager/Quality Assurance Reviewer

    Nextcase replied to telealli's topic in Case Management

    That sounds more like a QA job to me for sure not actual CM. In our organization all of our QA reviewers that review the CM documentation are RNs and most are also CCMs. I hope that you have a tough skin, because you will need it in this position.....

13. Utilization management question

    Nextcase replied to mayakovsky's topic in Case Management

    I don't do Medicaid. However, I do complex CM where I handle both the CM functions and the UM side of the case. First is it the actual review of records or the software that is confusing you? I am guessing it is the second and your learning curve w...

14. For nurses who work from home

    Nextcase replied to luvsfallin's topic in Case Management

    It is a fallacy that when you work from home you "set your own hours". In fact you will probably work more than your scheduled hours, especially if you are salaried. They have many ways to monitor when you are supposed to be working, right down to ...

15. American Health Holding (Aetna)

    Nextcase replied to C Roll 5's topic in Case Management

    facts about AHH. They pay much less than the Aetna pay scale. You are salaried and paid based on an 8 hr day...but are required to post 9 hrs of billable time each day and lots of your day is taken up by things you can not bill. So that translates i...