Case Manager / PRN ( RN / RT / SW / LPN )
Join to apply for the Case Manager / PRN ( RN / RT / SW / LPN ) role at Select Specialty Hospital.
Critical Illness Recovery Hospital
Shift: 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.
Requirements
Requires a current licensure in a clinical discipline either as a Nurse, a Respiratory Therapist, or Social Work (SW/MSW) as per state guidelines. Previous experience in a critical care setting is required. Previous discharge planning experience is highly preferred.
Responsibilities
Develops and implements a patient specific, safe and timely discharge plan.
Performs verification of utilization criteria reviews.
Builds relationships and coordinates 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.
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, identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage for the patient, and reviews insurance verification forms to minimize risk.
Facilitates multi‑disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Qualifications
Current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN), Respiratory Therapist or 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
Specific experience in Care Management and Discharge Planning.
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, from approximately 8 a.m. - 5 p.m.
Seniority Level
Entry level
Employment Type
Part‑time
Job Function
Health Care Provider
Industries
Wellness and Fitness Services, Hospitals and Health Care, and Medical Practices
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