Case Manager ( RN / RT / SW / LPN )

About the role

Select Specialty Hospital is seeking a Full-Time Case Manager to join our dedicated team. This position is available Monday through Friday from 8:00 AM to 5:00 PM.

Responsibilities

• Utilization reviews and resource management
• Discharge planning
• Treatment plan management and financial management
• Develops and implements a patient-specific, safe and timely discharge plan
• Verifies utilization criteria reviews
• Buys relationships and coordinates with payor sources to ensure proper reimbursement for hospital-provided services
• Fosters 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 Medical Social Work (license per state guidelines)
• Previous Discharge Planning Experience Preferred

Qualifications

• Current licensure in a clinical discipline either as a Nurse (RN preferred) 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 (example: ICU, step-down, med surg, vents)

Skills

• Patient-centered care
• Cost-effective care
• Teamwork and collaboration
• Compliance with policies and procedures
• Insurance industry knowledge
• Reimbursement negotiation skills

Benefits

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

Pay

Competitive salary based on experience and qualifications.

Schedule

Full-time position, Monday through Friday from 8:00 AM to 5:00 PM.