Case Manager – Critical Illness Recovery Hospital (LTACH)
Select Specialty Hospital
Full Time: Monday-Friday 8-5pm
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). Previous Discharge Planning Experience Preferred.
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 – and our team plays a central role in providing compassionate, excellent care every step of the way.
Case Manager responsibilities include 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.
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, promoting 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; assures the department identifies and negotiates 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.
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 (examples: ICU, step‑down, med‑surg, ventilator patients).
Preferred Qualifications
Specific experience in Care Management and Discharge Planning is preferred.
Working knowledge of the insurance industry and government reimbursement.
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