Case Manager (RN / RT / SW / LPN)
Select Specialty Hospital , located in Oklahoma City, OK.
Critical Illness Recovery Hospital (LTACH)
Full Time; Monday‑Friday, 8:00‑17:00.
Job Overview
The Case Manager is responsible for utilization reviews, discharge planning, treatment plan management, financial oversight, and documentation. The role reports to the Director of Case Management and includes providing social work services as required by state guidelines.
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 and promotes cost‑attentive care 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; assists the department in 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.
Minimum Requirements
Current licensure in a clinical discipline either as a Nurse (RN preferred, LPN, LVN) or as a Respiratory Therapist, or a licensed Social Work per state guidelines.
Previous inpatient experience with critical/acute care patients (e.g., ICU, step‑down, med‑surg, ventilator support).
Preferred Qualifications
Specific experience in Care Management and Discharge Planning.
Working knowledge of the insurance industry and government reimbursement.