Case Manager

3 weeks ago

Pontiac, United States Select Specialty Hospital Full time

Case Manager / PRN ( RN / RT / SW / LPN ) Select Specialty Hospital – Critical Illness Recovery Hospital (LTACH) is committed to providing world‑class inpatient post‑ICU services to chronic, critically ill patients. As a Case Manager, you will manage utilization reviews, discharge planning, treatment plan management, and financial management while completing medical record documentation. Licensure: Current licensure in a clinical discipline as a Nurse (RN/LPN/LVN), Respiratory Therapist, or Social Work (SW/MSW) per state guidelines. Shift Availability: Minimum of 2 shifts per month on an “as needed” basis. Shifts are scheduled on weekdays approximately 8 a.m.–5 p.m. Previous discharge planning experience highly preferred. Responsibilities Develop and implement a patient‑specific, safe and timely discharge plan. Perform verification of utilization criteria reviews. Build relationships and coordinate with payor sources to assure proper reimbursement for hospital‑provided services, promote cost‑attentive care via focus on resource management within the plan of care. Demonstrate compliance with facility‑wide Utilization Management policies and procedures. Coordinate UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled. Maintain fiscal responsibilities: identify and negotiate the fullest possible reimbursement to maximize insurance benefit coverage, review insurance verification forms to minimize risk. Facilitate multi‑disciplinary team meetings, including physicians, nurses, respiratory therapists and rehabilitation therapists. Success in this Environment We are seeking results‑driven team players who are passionate about providing superior quality care. Minimum Requirements Current licensure in a clinical discipline as a Nurse (RN/LPN/LVN), Respiratory Therapist, or 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 (e.g., ICU, step‑down, med‑surg, ventilated 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 Qualifications Specific experience in Care Management and Discharge Planning. Working knowledge of the insurance industry and government reimbursement. Availability to work a minimum of 2 shifts per month on an “as needed” basis with shifts scheduled weekdays 8 a.m.–5 p.m. Seniority Level Mid‑Senior level Employment Type Full‑time Job Function Health Care Provider Industries Hospitals and Health Care #J-18808-Ljbffr

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