Case Manager: Critical Care Discharge & Utilization (PTO)

Select Specialty Hospital; Detroit (MI); On-site; USD 72,000 - 105,000; Full time

Benefits offered by this job

Start Strong orientation

PTO & Paid Sick Time

Medical, Vision, Dental, EAP

401(k) retirement plan

Team of 44,000+ caring professionals

Job summary

Select Specialty Hospital in Detroit is seeking a Case Manager to oversee utilization reviews, discharge planning, and social work services for a LTAC. The role involves coordinating with payors and care teams to ensure appropriate and timely patient care and reimbursement.

The ideal candidate has current licensure in a clinical discipline (RN/LPN/LVN, RT) or Social Work and inpatient hospital experience in critical/acute care settings.

Qualifications

• Current licensure in a clinical discipline (RN/LPN/LVN) or Respiratory Therapist OR Social Work license per state guidelines.
• Previous inpatient hospital experience in critical care/acute care (ICU, step-down, med-surg, vents).

Responsibilities

• Develops a patient-specific, safe and timely discharge plan.
• Performs verification of utilization criteria reviews.
• Coordinates with payors to maximize reimbursement for hospital services.
• Demonstrates compliance with Utilization Management policies and procedures.
• Coordinates UR with Quality Management to meet licensure and accrediting requirements.
• Facilitates multidisciplinary team meetings including physicians and nurses.

Skills

Case management

Discharge planning

Utilization review

Medical record documentation

Education

RN/LPN/LVN license

Respiratory Therapist license

Social Work license

Tools

EMR/EHR systems

Job description

Select Specialty Hospital in Detroit is seeking a Case Manager to oversee utilization reviews, discharge planning, and social work services for a LTAC. The role involves coordinating with payors and care teams to ensure appropriate and timely patient care and reimbursement.

The ideal candidate has current licensure in a clinical discipline (RN/LPN/LVN, RT) or Social Work and inpatient hospital experience in critical/acute care settings.