Inpatient Case Manager – Discharge & Utilization

Select Specialty Hospital San Antonio Inc.; Charleston (WV); On-site; USD 65,000 - 90,000; Full time

Job summary

Select Specialty Hospital is seeking a Case Manager to join our Critical Illness Recovery Hospital team. This full-time role supports discharge planning, utilization reviews, and care coordination for medically complex patients in inpatient settings.

You will collaborate with physicians, nurses, RTs and social workers, manage treatment and financial plans, and ensure adherence to state licensing guidelines.

Qualifications

• 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.
• Previous Discharge Planning Experience Preferred.

Responsibilities

• 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.

Job description

Select Specialty Hospital is seeking a Case Manager to join our Critical Illness Recovery Hospital team. This full-time role supports discharge planning, utilization reviews, and care coordination for medically complex patients in inpatient settings.

You will collaborate with physicians, nurses, RTs and social workers, manage treatment and financial plans, and ensure adherence to state licensing guidelines.