Case Manager ( RN / RT / SW / LPN )

Regency Hospital - Central Georgia • Macon, GA

1d • $70,000 - $95,000

About The Position

Select Specialty Hospital, a critical illness recovery hospital (LTACH), is seeking a Case Manager to support chronic, critically ill patients who require extended healing and recovery following intensive care. The Case Manager manages utilization reviews and resources, discharge planning, treatment plans, financial matters, and medical record documentation. The role also provides social work services as necessary, in accordance with state guidelines. The position reports directly to the Director of Case Management and is full-time, Monday through Friday, 8 a.m. to 5 p.m. Salary is $70,000–$95,000, based on relevant prior experience.

Requirements

• Current licensure in a clinical discipline as a nurse (RN/LPN/LVN) or respiratory therapist, or a current social work license/certification in accordance with 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 utilization criteria verification reviews.
• Build relationships and coordinate with payor sources to support appropriate reimbursement and resource-conscious care.
• Comply with facility-wide Utilization Management policies and procedures.
• Coordinate utilization review compliance with Quality Management to meet licensure and accreditation requirements.
• Maintain fiscal responsibilities, including identifying and negotiating reimbursement and maximizing insurance benefit coverage for patients.
• Review insurance verification forms to minimize risk.
• Facilitate multidisciplinary team meetings with physicians, nurses, respiratory therapists, and rehabilitation therapists.
• Complete medical record documentation and 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