Case Manager

1 week ago

Mount Clemens, Michigan, United States Select Specialty Hospital Full time $60,000 - $120,000 per year

Critical Illness Recovery Hospital
Case Manager
$10,000 Sign On Bonus
Requires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state guidelines).

And

Previous Experience In Critical Care Required.
Previous discharge planning experience preferred.

At Select Specialty Hospital and 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

Responsibilities
We 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.

The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.

  • Develops and implements a patient specific, safe and timely discharge plan.
  • Performs verification of utilization criteria reviews.
  • Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
  • Demonstrates compliance with facility-wide Utilization Management policies and procedures.
  • Coordinates UR compliance with Quality Management to assure 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.

Qualifications
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 discipline either as a Nurse or a Respiratory Therapist (RN preferred) OR current license / certified Social Work license per state guidelines
  • Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)

Preferred qualifications that will make you successful:

  • Specific experience in Care Management and Discharge Planning is preferred.
  • Working knowledge of the insurance industry and government reimbursement.

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