Inpatient Case Manager | Discharge & Utilization Specialist

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

Job summary

Select Specialty Hospital is seeking a Case Manager at its Critical Illness Recovery Hospital (LTACH) to oversee discharge planning, utilization reviews and treatment plan management. This full-time role reports to the Director of Case Management and involves maintaining medical record documentation and coordinating with payors.

This position requires active licensure in a clinical discipline (RN/LPN/LVN or RT) or a Social Work license per state guidelines, with prior inpatient hospital

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

Responsibilities

• Develops patient-specific discharge plans.
• Performs verification of utilization criteria reviews.
• Coordinates with payor sources to ensure proper reimbursement.
• Ensures compliance with Utilization Management policies and procedures.
• Facilitates UR coordination with Quality Management for licensure/accreditation.
• Maintains fiscal responsibilities and maximizes insurance coverage.
• Leads multi-disciplinary team meetings with physicians, nurses, RTs and rehabilitation therapists.

Skills

Case management

Utilization review

Discharge planning

Interdisciplinary collaboration

Education

RN

LPN/LVN

Respiratory Therapist (RT)

Social Work license

Job description

Select Specialty Hospital is seeking a Case Manager at its Critical Illness Recovery Hospital (LTACH) to oversee discharge planning, utilization reviews and treatment plan management. This full-time role reports to the Director of Case Management and involves maintaining medical record documentation and coordinating with payors.

This position requires active licensure in a clinical discipline (RN/LPN/LVN or RT) or a Social Work license per state guidelines, with prior inpatient hospital