Case Manager ( RN / RT / SW / LPN )

Select Medical; Miami (FL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Orientation program

PTO & Paid Sick Time

Health benefits (medical/RX/vision/del

401(k) retirement plan

Life and disability insurance

Employee assistance program

Job summary

Select Specialty Hospital in Miami is seeking a Case Manager to join our full-time team. The role focuses on utilization reviews, discharge planning, treatment plan management and social work services per state guidelines.

You will report to the Director of Case Management and collaborate with physicians, nurses and rehabilitation therapists to ensure timely, patient-centered care and appropriate reimbursement.

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 inpatient hospital discharge planning experience preferred.

Responsibilities

• Develops and implements a patient-specific, safe and timely discharge plan.
• Performs verification of utilization criteria reviews.
• Builds relationships with payor sources to assure proper reimbursement for hospital services and optimize insurance coverage.
• Demonstrates compliance with Utilization Management policies and procedures.
• Coordinates UR compliance with Quality Management to meet licensure and accrediting requirements.
• Maintains fiscal responsibilities and reviews insurance verification to minimize risk.
• Facilitates multi-disciplinary team meetings with physicians, nurses, therapists.

Skills

Discharge planning

Utilization review

Care management

Documentation

Interdisciplinary teamwork

Education

Nursing license (RN/LPN/LVN) or RT license

Social Work license

Job description

Overview

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).

And

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.

Responsibilities

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.

Qualifications

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 qualificationsthat will make you successful:

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

Additional Data

General Benefits Full-time

• Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
• Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
• Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
• Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
• Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans