Case Manager / PRN ( RN / RT / SW / LPN )

Case Manager / PRN ( RN / RT / SW / LPN )

Case Manager / PRN ( RN / RT / SW / LPN ) position with Select Specialty Hospital. The role focuses on utilization reviews, discharge planning, treatment plan management and financial management, with social work services as required 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 services and promotes cost-conscious care through resource management within the plan of care.
• Demonstrates compliance with facility-wide Utilization Management policies and procedures.
• Coordinates UR compliance with Quality Management to ensure licensure and accrediting requirements are fulfilled.
• Maintains fiscal responsibilities; identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage. 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/LPN/LVN) or a Respiratory Therapist OR current license/certified Social Work license per state guidelines.
• Previous inpatient hospital experience in an acute/critical care setting (e.g., ICU, step-down, med-surg, vents) as RN/LPN/RT/SW/CM.
• Experience in acute medical case management with the ability 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 on weekdays approximately 8 a.m.–5 p.m.

Shift

Availability to work a minimum of 2 shifts per month on an "as needed" basis – shifts would be scheduled on weekdays, approximately 8:00 a.m.–5:00 p.m.

At Select Specialty Hospitals 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 serves about 70,000 patients daily 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 living our cultural behaviors: celebrating success, owning the future, being patient-centered, creating change, thinking first and building trust.

About the Role in Our Environment

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 report to the Director of Case Management and provide social work services as required per state guidelines.

We are looking for results-driven team players who are passionate about providing superior quality in all tasks. We strive to put the patient first and support high-quality care while exploring new ideas and maintaining integrity.