Clinical Case Manager

4 weeks ago


Springfield, Illinois, United States Select Medical Full time
Job Summary

We are seeking a highly skilled Clinical Case Manager to join our team at Select Medical. As a key member of our critical illness recovery hospital, you will be responsible for utilization reviews and resource management, discharge planning, treatment plan management, and financial management.

Key Responsibilities:

  • Develop and implement patient-specific, safe, and timely discharge plans
  • Perform verification of utilization criteria reviews
  • Build relationships and coordinate with payor sources to ensure proper reimbursement for hospital-provided services
  • Demonstrate compliance with facility-wide Utilization Management policies and procedures
  • Coordinate UR compliance with Quality Management to ensure all licensure and accrediting requirements are fulfilled
  • Maintain fiscal responsibilities and ensure the department identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage for the patient

Requirements:

  • Current licensure in a clinical discipline (Nurse, Respiratory Therapist, or Medical Social Work)
  • Previous experience in critical care and discharge planning
  • Working knowledge of the insurance industry and government reimbursement

What We Offer:

  • An extensive and thorough orientation program
  • A Monday-through-Friday schedule with six paid holidays
  • Unlimited employee referral bonus incentives
  • 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

Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer.



  • Springfield, Illinois, United States CVS Health Full time

    Job SummaryClinical Case Manager, Behavioral HealthClinical Case Manager, Behavioral Health, is a key role at CVS Health, where we strive to deliver enhanced human-centric healthcare for a rapidly changing world. As a Clinical Case Manager, Behavioral Health, you will play a vital part in our mission to bring our heart to every moment of our patients'...


  • Springfield, Illinois, United States CVS Health Full time

    Job Summary:CVS Health is seeking a skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will be responsible for managing a full caseload of waiver members, providing care coordination, support, and education to ensure optimal healthcare outcomes.Key Responsibilities:Conduct comprehensive evaluations of referred members' needs and...


  • Springfield, Illinois, United States Northeast Center for Youth & Families, Inc. (NCYF) Full time

    Job Summary:We are seeking a highly skilled Clinical Case Manager/Educational Liaison to join our team at Northeast Center for Youth and Families, Inc. (NCYF).The successful candidate will be responsible for providing clinical, collateral case management, ongoing assessments, and aftercare services to our youth. They will also act as an Educational Liaison...


  • Springfield, Illinois, United States CVS Health Full time

    Job SummaryWe are seeking a skilled Clinical Case Manager to join our team at CVS Health. As a Clinical Case Manager, you will play a critical role in facilitating appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support, and education through the use of care management tools and resources.Key ResponsibilitiesConduct...


  • Springfield, Illinois, United States CVS Health Full time

    Job SummaryCVS Health is seeking a skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a critical role in facilitating appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services.Key...

  • Nurse Case Manager

    4 weeks ago


    Springfield, Illinois, United States Inova Health System Full time

    Inova Health System is seeking a skilled Registered Nurse to fill a Case Management position.Job DescriptionThe RN Case Manager will provide discharge planning and continuity of care for assigned patients in acute and post-acute settings.Key ResponsibilitiesCollects and analyzes data to identify areas for improvement and drives practice changes to positively...

  • Case Manager RN

    4 weeks ago


    Springfield, Illinois, United States CVS Health Full time

    Job Summary:The Case Manager RN position at CVS Health is a 100% remote opportunity that allows employees to live in any state, with most having an Illinois RN license. This role is part of Aetna's Commercial Care Management division.Key Responsibilities:Telephonically and/or face-to-face assess, plan, implement, and coordinate all case management activities...

  • Case Manager

    1 month ago


    Springfield, Illinois, United States Children's Study Home Full time

    Comprehensive Foster Care Program**Job Summary**Helix Human Services is seeking a skilled Case Manager to provide intensive case management to children and youth referred by the Department of Children and Families (DCF) to the Comprehensive Foster Care program (CFC).**Key Responsibilities:**• Provide case management supports to children and adolescent...


  • Springfield, Illinois, United States Inova Full time

    Job Title: Social Worker Case ManagerAt Inova, we are seeking a highly skilled Social Worker Case Manager to join our team. This role is responsible for evaluating the ability of patients to progress throughout the continuum of care, working collaboratively with physicians, nursing, and other members of the multidisciplinary care team to effect timely and...


  • Springfield, Illinois, United States CVS Health Full time

    Transforming Patient Care with Compassion and ExcellenceCVS Health is seeking a dedicated and compassionate Case Manager RN to join our team. As a key member of our Aetna team, you will play a vital role in delivering exceptional patient care to our dual eligible populations.Program OverviewOur Case Manager RN will work closely with members, providers, and...

  • RN Case Manager

    4 weeks ago


    Springfield, Illinois, United States Effingham Health System Full time

    Job SummaryAs a RN Case Manager with Effingham Health System, you will play a critical role in ensuring the highest quality patient care and outcomes. Under the general direction of the Director of Transitional Care, you will be accountable for a designated patient caseload and plan effectively to meet patient needs, manage the length of stay, and promote...


  • Springfield, Illinois, United States CVS Health Full time

    Transforming Patient CareCVS Health is seeking a dedicated and compassionate Case Manager RN to join our team. As a key member of our Aetna team, you will play a vital role in elevating patient care to new heights.Program OverviewOur Case Manager RN will work closely with members, providers, and community organizations to address the full continuum of health...


  • Springfield, Illinois, United States Baystate Health Full time

    Job Summary:The Case Management Assistant will work collaboratively with patients and Case Managers to communicate and document accurate clinical and regulatory information. This role requires strong communication and organizational skills to effectively collaborate with internal and external partners to address financial advocacy for the...


  • Springfield, Illinois, United States Baystate Health Full time

    Hospital Case Manager Job DescriptionThe Hospital Case Manager is a registered nurse responsible for coordinating clinical care, quality, and financial outcomes of a designated population of patients.Key Responsibilities:Facilitate patient care plans as outlined in the plan of careLead daily patient care huddles with nursing to direct timely progress along...

  • Case Manager

    1 month ago


    Springfield, Illinois, United States UnitedHealth Group Full time

    Job Title: Case ManagerAt UnitedHealth Group, we're committed to simplifying the healthcare experience and creating healthier communities. As a Case Manager, you'll play a vital role in removing barriers to quality care and making a meaningful impact on the lives of millions of people.Key Responsibilities:Serve as primary care manager for high-risk members...


  • Springfield, Illinois, United States CVS Health Full time

    Job Summary:CVS Health is seeking a skilled Case Manager RN to join our Community Care team. As a Case Manager RN, you will play a critical role in delivering high-quality patient care and promoting wellness activities.Key Responsibilities:Facilitate the delivery of appropriate benefits and/or healthcare information to determine eligibility for benefits...


  • Springfield, Illinois, United States CVS Health Full time

    Job SummaryCVS Health is seeking a highly skilled Case Manager RN to join our Community Care team. As a key member of our team, you will be responsible for facilitating the delivery of appropriate benefits and healthcare information to our members, while promoting wellness activities and developing strategies to ensure timely return to work.Key...


  • Springfield, Illinois, United States Medical Solutions Full time

    Job Title: Travel Nurse RNMedical Solutions is seeking a skilled travel nurse RN to join our team as a Case Manager, Utilization Review. This exciting opportunity is available in Springfield, Missouri, and offers a unique blend of clinical expertise and business acumen.Job Summary:We are looking for a talented RN with a strong background in case management...


  • Springfield, Illinois, United States CVS Health Full time

    Job SummaryThe Case Management Coordinator plays a critical role in facilitating healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits, and educating members through the use of care management tools and resources.Key ResponsibilitiesCollaborate with healthcare providers to...

  • Nurse Case Manager

    1 month ago


    Springfield, Illinois, United States DaVita Full time

    Job Title: Peritoneal Dialysis Registered NurseWe are seeking a highly motivated and organized Peritoneal Dialysis Registered Nurse to join our team. As a Peritoneal Dialysis Registered Nurse, you will be responsible for providing comprehensive patient care in an independent setting. You will work closely with patients and their care partners to educate them...