Clinical Case Manager
1 week ago
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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