Case Manager ( RN / RT / SW / LPN )

About the role

Select Specialty Hospital is seeking a Full-Time Case Manager to join our dedicated team. The ideal candidate will have a current licensure in a clinical discipline such as Nursing (RN/LPN/LVN), Respiratory Therapy (RT), or Medical Social Work (licensed per state guidelines), along with previous discharge planning experience.

Responsibilities

• Utilization reviews and resource management
• Discharge planning
• Treatment plan management and financial management
• Medical record documentation
• Develops and implements a patient-specific, safe, and timely discharge plan
• Verifies utilization criteria reviews
• Builts relationships and coordinates with payor sources to ensure proper reimbursement for hospital-provided services
• Promotes cost-effective care by focusing on resource management within the plan of care
• Demonstrates compliance with facility-wide Utilization Management policies and procedures
• Coordinates UR compliance with Quality Management to ensure all licensure and accrediting requirements are fulfilled
• 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
• Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists, and rehabilitation therapists

Requirements

• Current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT)
• OR current license/certified Social Work license per state guidelines
• Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients

Qualifications

• Specific experience in Care Management and Discharge Planning is preferred
• Working knowledge of the insurance industry and government reimbursement

Skills

• Compassion and empathy
• Strong communication skills
• Excellent organizational and time management skills
• Ability to work independently and as part of a team
• Knowledge of healthcare regulations and reimbursement processes

Benefits

We offer a comprehensive benefits package including health insurance, retirement plans, paid time off, and more.

Pay

$XX.XX - $XXX.XX per hour based on experience and qualifications.

Schedule

Monday-Friday, 8:00 AM - 5:00 PM