Case Manager ( RN / RT / SW / LPN )

Case Manager – Critical Illness Recovery Hospital (LTACH)

Full Time: Monday‑Friday 8‑5pm

Current licensure in a clinical discipline - either as a Nurse (RN/LPN/LVN), a Respiratory Therapist (RT), or Medical Social Work (state‑licensed). Previous discharge planning experience is preferred.

Our hospital is a critical illness recovery hospital committed to providing world‑class inpatient post‑ICU services to chronic, critically ill patients. As a Case Manager you will lead utilization reviews, discharge planning, treatment plan management, and financial management while completing medical record documentation.

Responsibilities

• Develop and implement patient‑specific, safe and timely discharge plans.
• Perform verification of utilization criteria reviews.
• Build relationships and coordinate with payor sources to assure proper reimbursement for hospital‑provided services, promoting cost‑attentive care via resource management within the plan of care.
• Demonstrate compliance with facility‑wide Utilization Management policies and procedures.
• Coordinate UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
• Maintain fiscal responsibilities; identify and negotiate the fullest possible reimbursement to maximize insurance benefit coverage for the patient; review insurance verification forms to minimize risk.
• Facilitate multidisciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.

Minimum Requirements

• Current licensure in a clinical discipline as a Nurse (RN preferred) or Respiratory Therapist, or a state‑licensed Social Work license.
• Previous inpatient hospital experience with critical care/acute care patients (e.g., ICU, step‑down, med‑surg, ventilator support).

Preferred Qualifications That Will Make You Successful

• Specific experience in care management and discharge planning.
• Working knowledge of the insurance industry and government reimbursement.