Clinical Case Manager

1 week 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.


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