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Director of Case Management
4 months ago
Critical Illness Recovery Hospital
Director of Case Management
Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience.
Previous case mangement ( discharge planning ) experience with medically complex patients in a hospital critical care setting and supervisory experience.
At Select Specialty/Regency Hospitals, a division of Select Medical, we care for chronically and critically ill or post-ICU patients who require extended hospital care. Select Medical employs over 48,000 people across the country and provides quality care to approximately 70,000 patients each and every day across our four divisions.
Our mission is to provide an exceptional patient care experience that promotes healing and recovery in a compassionate environment. Each employee plays a vital role in doing that by living our cultural behaviors - celebrating success, owning the future, being patient-centered, creating change, thinking first and building trust.
Are you resourceful in overcoming obstacles? Are you a results-oriented team player? If you answered 'yes', consider an opportunity with us
ResponsibilitiesWe are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.
As the Director of Case Management, you will use your clinical knowledge and contribute to the overall functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan management and financial management effectiveness.
- Developing and implementing a patient-specific, safe and timely discharge plan.
- Performing verification of utilization criteria reviews.
- Building relationships and coordinating with payor sources in order to ensure proper reimbursement for hospital provided services and to promote cost attentive care via a focus on resource management.
- Demonstrating compliance with facility-wide Utilization Management policies and procedures.
- Coordinating UR compliance with Quality Management to ensure all licensure and accrediting requirements are fulfilled.
- Maintains fiscal responsibilities. Assures the department is identifying and negotiating 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.
We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.
Minimum requirements:
- Current licensure in a clinical or a related discipline.
- Minimum three (3) years of medical case management or similar experience.
- Two (2) years of experience in either (a) managing a case management department; or (b) case management at Select Medical with demonstrated effective leadership skills. (Internal candidate must have consistently achieved set objectives and must be recommended by the hospital CEO).
Preferred qualifications that will make you successful:
- Current RN licensure preferred.
- Working knowledge of the insurance industry and government reimbursement.
Select Medical strives to provide our employees with work-life balance, as we understand that happy employees have both fulfilling careers and fulfilling lives beyond our doors.
- An extensive and thorough orientation program.
- Monday through Friday schedule; six (6) paid holidays.
- Develop collaborative relationships with patients and their families.
- Paid Time Off (PTO) and Extended Illness Days (EID).
- Health, Dental, and Vision insurance; Life insurance; Prescription coverage.
- A 401(k) retirement plan with company match.
- Short and Long Term Disability.
- Personal and Family Medical Leave.
We'd love for you to join the team
Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer. Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.
