Case Manager ( RN / RT / SW / LPN )

Overview 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. 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. 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. 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 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 Specific experience in Care Management and Discharge Planning is preferred. Working knowledge of the insurance industry and government reimbursement. We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr