Requires a current license in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state guidelines).
Availability to work a minimum of 2 shifts per month on an “as needed” basis. Shifts would be scheduled on weekdays, approximately 8 a.m. – 5 p.m.
Our hospital is a critical illness recovery hospital committed to providing world‑class inpatient post‑ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives—our team plays a central role in providing compassionate, excellent care every step of the way.
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.
Responsibilities
Develop and implement a patient‑specific, safe and timely discharge plan.
Perform verification of utilization criteria reviews.
Build relationships and coordinate with payor sources to assure proper reimbursement for hospital‑provided services, promote cost‑attentive care via focus on resource management within the plan of care.
Demonstrate compliance with facility‑wide Utilization Management policies and procedures.
Coordinate UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
Maintain fiscal responsibilities; identify and negotiate the fullest possible reimbursement to maximize insurance benefit coverage for the patient; review insurance verification forms to minimize risk.
Facilitate multidisciplinary team meetings including physicians, nurses, respiratory therapists, and rehabilitation therapists.
How you will be successful in this environment
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 (RN / LPN / LVN) or a Respiratory Therapist 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 (e.g., ICU, step‑down, med‑surg, vents).
Adequate experience in an acute medical case‑management setting and confidence to manage and direct a plan of care for chronically critically ill populations.
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.
Availability to work a minimum of 2 shifts per month on an “as needed” basis; shifts would be scheduled on weekdays, approximately 8 a.m. – 5 p.m.