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Case Management Executive

2 months ago

Jackson, Tennessee, United States Select Specialty Hospital Full time
Position Overview

Specialty Care Facility

Case Management Executive

Sign-On Incentive Available

Must possess a clinical license as a registered nurse, respiratory therapist, or a master's degree in social work, along with a minimum of three (3) years of experience in medical case management or a related field.

Experience in case management, particularly in discharge planning for patients with complex medical needs in a critical care environment, along with supervisory experience, is essential.

At Select Specialty Hospitals, a part of Select Medical, we specialize in the care of patients who are chronically and critically ill or those recovering from intensive care. Our organization employs over 48,000 professionals nationwide, delivering quality healthcare to approximately 70,000 patients daily across our various divisions.

Our mission is to ensure an outstanding patient care experience that fosters healing and recovery in a supportive atmosphere. Every team member plays a crucial role in achieving this by embodying our core values - celebrating achievements, taking ownership of the future, prioritizing patient needs, driving innovation, thinking critically, and building trust.

Are you adept at navigating challenges? Are you a collaborative team player? If so, we invite you to explore this opportunity.

Key Responsibilities

We seek dedicated individuals who will embody the principles of the Select Medical Way, which emphasizes patient-centered care, enhancing community quality of life, fostering innovation, delivering high-quality services, and adhering to ethical practices.

As the Case Management Executive, you will leverage your clinical expertise to enhance departmental functions and support professional development, including but not limited to: Utilization Review (UR), resource management, discharge planning, treatment plan oversight, and financial management efficiency.

  • Creating and executing individualized, safe, and timely discharge plans for patients.
  • Conducting verification of utilization criteria assessments.
  • Establishing relationships and collaborating with payor sources to ensure appropriate reimbursement for services rendered and to promote cost-effective care through resource management.
  • Ensuring adherence to facility-wide Utilization Management policies and procedures.
  • Coordinating UR compliance with Quality Management to meet all licensure and accreditation standards.
  • Managing fiscal responsibilities, ensuring the department maximizes reimbursement opportunities and minimizes risk through thorough insurance verification.
  • Facilitating interdisciplinary team meetings involving physicians, nursing staff, respiratory therapists, and rehabilitation specialists.
Qualifications

We are looking for results-oriented team members. Ideal candidates should be committed to delivering exceptional quality in all aspects of their work.

Minimum qualifications include:

  • Current licensure in a clinical or related field.
  • A minimum of three (3) years of experience in medical case management or a similar role.
  • At least two (2) years of experience in either (a) managing a case management department or (b) case management within Select Medical, demonstrating effective leadership capabilities. (Internal candidates must have consistently met performance objectives and received recommendations from the hospital CEO).

Preferred qualifications that will enhance your success:

  • Current RN licensure is preferred.
  • Familiarity with the insurance sector and government reimbursement processes.
Additional Information

Select Medical is dedicated to providing our employees with a balanced work-life experience, recognizing that satisfied employees thrive both professionally and personally.

  • Comprehensive orientation program.
  • Standard Monday through Friday work schedule; six (6) paid holidays.
  • Opportunities to build 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 matching.
  • Short and Long Term Disability benefits.
  • Personal and Family Medical Leave options.

We look forward to welcoming you to our team.

Select Medical is committed to fostering a diverse workforce 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.