Case Manager / PRN ( RN / RT / SW / LPN )

About the role

The Case Manager at Select Specialty Hospital Critical Illness Recovery Hospital (LTACH) is responsible for utilizing reviews, resource management, discharge planning, treatment plan management, and financial management. They also complete medical record documentation and provide social work services, as necessary, per state guidelines.

Responsibilities

• Develops and implements a patient-specific, safe, and timely discharge plan.
• Performs verification of utilization criteria reviews.
• Buils relationships and coordinates with payor sources to assure proper reimbursement for hospital-provided services, promoting cost-effective care via focus on resource management within the plan of care.
• Demonstrates compliance with facility-wide Utilization Management policies and procedures.
• Collaborates with multi-disciplinary teams including physicians, nurses, respiratory therapists, and rehabilitation therapists to facilitate meetings.
• Maintains fiscal responsibilities, ensuring the department identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage for the patient.
• Reviews insurance verification forms to minimize risk.

Requirements

• Current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN), Respiratory Therapist, or Social Work license (SW/MSW).
• Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients.
• Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations.
• Preferred specific experience in Care Management and Discharge Planning.
• Working knowledge of the insurance industry and government reimbursement.

Qualifications

• Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from approximately 8a.m.-5p.m.

Skills

• Excellent communication skills.
• Strong organizational and time management skills.
• Ability to work independently and as part of a team.
• Proficiency in healthcare software and systems.

Benefits

Our hospital offers competitive benefits packages, including health insurance, retirement plans, and paid time off.

Pay

Compensation is commensurate with experience.

Schedule

Shifts would be scheduled on weekdays, from approximately 8a.m.-5p.m., with availability to work a minimum of 2 shifts per month.