Case Manager / PRN ( RN / RT / SW / LPN )

Select Specialty Hospital Tallahassee • Tallahassee, FL

95d

About The Position

The Critical Illness Recovery Hospital Case Manager (PRN) position requires a current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state guidelines). Previous experience in a critical care setting is required, and previous discharge planning experience is highly preferred. The role involves working a minimum of 2 shifts per month on an 'as needed' basis, with shifts scheduled on weekdays from approximately 8 a.m. to 5 p.m. At Select Specialty Hospitals and Regency Hospitals, a division of Select Medical, we care for chronically and critically ill or post-ICU patients who require extended hospital care. Select Medical employs over 48,000 people across the country and provides quality care to approximately 70,000 patients each and every day across our four divisions. Our mission is to provide an exceptional patient care experience that promotes healing and recovery in a compassionate environment. Each employee plays a vital role in doing that by living our cultural behaviors - celebrating success, owning the future, being patient-centered, creating change, thinking first and building trust.

Requirements

• Current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist 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).
• Adequate experience in an acute medical case management setting.
• Confidence to manage and direct a plan of care for chronically critically ill populations.

Nice To Haves

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

Responsibilities

• Responsible for utilization reviews and resource management.
• Conduct discharge planning and treatment plan management.
• Manage financial responsibilities and complete medical record documentation.
• Report directly to the Director of Case Management.
• Provide social work services as necessary per state guidelines.
• Develop and implement a patient-specific, safe, and timely discharge plan.
• Perform verification of utilization criteria reviews.
• Build relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services.
• Promote cost-attentive care via focus on resource management within the plan of care.
• Demonstrate compliance with facility-wide Utilization Management policies and procedures.
• Coordinate UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
• Assure the department identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage for the patient.
• Review insurance verification forms to minimize risk.
• Facilitate multi-disciplinary team meetings including physicians, nurses, respiratory therapists, and rehabilitation therapists.

Benefits

• Work-life balance.
• Diversity and equal opportunity employer.

What This Job Offers

• Industry: Hospitals