Director of Case Management ( RN / RT / MSW / LPN )

Select Specialty Hospital; Pontiac (MI); On-site; USD 120,000 - 180,000; Full time

Job summary

Select Specialty Hospital in Michigan is seeking a Director of Case Management for our Critical Illness Recovery Hospital (LTACH). This full-time role requires clinical licensure (RN or RT) or a Master's in Social Work with at least three years in medical case management, including discharge planning for medically complex patients.

You will lead UR and resource management, coordinate with payors, oversee treatment and financial management, and supervise the case management team.

Qualifications

• Current licensure in a clinical discipline.
• Minimum three (3) years of medical case management or similar experience.
• Two (2) years of leadership in a case management department or related role. Internal candidates require CEO recommendation.

Responsibilities

• Develop and oversee UR (utilization review) and discharge planning processes for medically complex patients.
• Coordinate with payors to ensure appropriate reimbursement for hospital services.
• Manage financial aspects and resource allocation within the case management department.
• Lead and mentor the case management team and supervise staff performance.
• Facilitate multidisciplinary team meetings with physicians, nurses, respiratory therapists and rehab specialists.

Skills

RN license

Respiratory Therapist license

Supervisory experience

Discharge planning experience

UR knowledge

Education

Master's in Social Work

Job description

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

Director of Case Management

Full Time: Monday - Friday 8-5pm

Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience.

Previous case mangement ( discharge planning ) experience with medically complex patients in a hospital critical care setting and supervisory experience.

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.

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

Director of Case Management

Full Time: Monday - Friday 8-5pm

Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience.

Previous case mangement ( discharge planning ) experience with medically complex patients in a hospital critical care setting and supervisory experience.

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.

As the Director of Case Management, you will use your clinical knowledge and contribute to the overall functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan management and financial management effectiveness.

• Developing and implementing a patient-specific, safe and timely discharge plan.
• Performing verification of utilization criteria reviews.
• Building relationships and coordinating with payor sources in order to ensure proper reimbursement for hospital provided services and to promote cost attentive care via a focus on resource management.
• Demonstrating compliance with facility-wide Utilization Management policies and procedures.
• Coordinating UR compliance with Quality Management to ensure 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 or a related discipline.
• Minimum three (3) years of medical case management or similar experience.
• Two (2) years of experience in either (a) managing a case management department; or (b) case management at Select Medical with demonstrated effective leadership skills. (Internal candidate must have consistently achieved set objectives and must be recommended by the hospital CEO).

Preferred Qualifications That Will Make You Successful

• Current RN licensure preferred.
• Working knowledge of the insurance industry and government reimbursement.