Licensed Social Worker Case Manager / PRN

About the role

Select Specialty Hospital is a critical illness recovery hospital dedicated to providing world-class inpatient post-ICU services to chronic, critically ill patients. The Case Manager plays a central role in providing compassionate, excellent care and ensuring proper reimbursement for hospital provided services.

Responsibilities

• Develops and implements a patient-specific, safe, and timely discharge plan.
• Performs verification of utilization criteria reviews.
• Builds relationships and coordinates with payor sources to ensure proper reimbursement for hospital provided services, promoting cost-effective care through focus on resource management within the plan of care.
• Demonstrates compliance with facility-wide Utilization Management policies and procedures.
• Collaborates 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.
• Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations.
• Specific experience in Care Management and Discharge Planning is preferred.
• Working knowledge of the insurance industry and government reimbursement.

Qualifications

• Passionate about providing superior quality in all that they do.

Skills

• Compassion and empathy for patients and families.
• Strong organizational and communication skills.
• Ability to work independently and as part of a team.
• Knowledge of healthcare regulations and reimbursement processes.

Benefits

• Comprehensive benefits package.

Pay

$52/hr

Schedule

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