Hospital Case Manager: Discharge Planning & Utilization

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

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.