Case Manager ( RN / RT / SW / LPN )

Select Specialty Hospital; Miami (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

Select Specialty Hospital in Miami, FL is seeking a Case Manager to oversee utilization reviews, discharge planning, and treatment plan management in a LTACH setting. The role reports to the Director of Case Management and requires current licensure in a clinical discipline (RN/LPN/LVN, RT) or a Medical Social Work license per state guidelines.

Preferred candidates have prior discharge planning experience and inpatient hospital exposure to critical care settings.

Qualifications

• 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.
• Experience in inpatient hospital setting with critical/acute care patients (ICU, step-down, med surg, vents).

Responsibilities

• Responsible for utilization reviews and resource management, discharge planning and treatment plan management.
• Manage financial aspects and complete medical record documentation; report to Director of Case Management.
• Coordinate with payor sources to maximize reimbursement and promote cost-conscious care.
• Facilitate multidisciplinary team meetings including physicians, nurses, RTs and rehabilitation therapists.

Skills

Nurse licensure (RN/LPN/LVN)

Respiratory Therapist

Social Work license

Job description

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

Case Manager

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.

We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.

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.

• Develops and implements a patient specific, safe and timely discharge plan.
• Performs verification of utilization criteria reviews.
• Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs 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.

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. (example: ICU, step-down, med surg, vents)

Preferred Qualifications That Will Make You Successful

• Specific experience in Care Management and Discharge Planning is preferred.
• Working knowledge of the insurance industry and government reimbursement.