Case Manager ( RN / RT / SW / LPN )

Select Specialty Hospital - Grosse Pointe • Grosse Pointe Farms, MI

2d • $72,000 - $105,000

About The Position

Select Specialty Hospital is a critical illness recovery hospital providing inpatient post-ICU services to chronically and critically ill patients who need extended healing and recovery. The Case Manager manages utilization reviews and resources, discharge planning, treatment plans, financial management, and medical-record documentation. The role also provides social work services as necessary and as permitted by state guidelines. The Case Manager reports directly to the Director of Case Management and works to provide compassionate, high-quality patient care.

Requirements

• Current licensure in a clinical discipline as a nurse or respiratory therapist, or a current social work license or certification per state guidelines.
• Previous RN, LPN, RT, SW, or case management experience in an inpatient hospital setting with critical-care or acute-care patients, such as ICU, step-down, medical-surgical, or ventilator patients.

Nice To Haves

• RN licensure is preferred.
• Specific experience in care management and discharge planning.
• Working knowledge of the insurance industry and government reimbursement.

Responsibilities

• Develop and implement patient-specific, safe, and timely discharge plans.
• Perform verification of utilization criteria reviews.
• Build relationships and coordinate with payor sources to support proper reimbursement and cost-conscious resource management.
• Comply with facility-wide Utilization Management policies and procedures.
• Coordinate utilization review compliance with Quality Management to meet licensure and accrediting requirements.
• Maintain fiscal responsibilities, identify and negotiate reimbursement to maximize insurance benefit coverage, and review insurance verification forms to minimize risk.
• Facilitate multidisciplinary team meetings involving physicians, nurses, respiratory therapists, and rehabilitation therapists.
• Complete medical-record documentation.
• Provide social work services, as necessary, per state guidelines.

Benefits

• Extensive orientation program.
• Generous paid time off and paid sick time for full-time team members.
• Medical, prescription, health, vision, employee assistance program, and dental plan offerings for full-time team members.
• Company-matching 401(k) retirement plan.
• Life and disability protection for full-time team members.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed