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

Select Medical • Gainesville, FL

2d

About The Position

Select Specialty Hospital, a critical illness recovery hospital (LTACH), provides inpatient post-ICU services to chronically critically ill patients who need extended healing and recovery. The Case Manager supports patient care through utilization review and resource management, discharge planning, treatment plan management, financial management, and medical-record documentation. The role may provide social work services as needed, in accordance with state guidelines. The Case Manager develops safe, timely, patient-specific discharge plans; reviews utilization criteria; coordinates with payors to support reimbursement and resource-conscious care; and works with the Quality Management team to meet utilization-management, licensure, and accreditation requirements. The role also supports fiscal responsibility, insurance-benefit coverage, and multidisciplinary care coordination. This is a PRN, as-needed position requiring availability for at least two weekday shifts per month, approximately 8 a.m. to 5 p.m. Pay is $41 per hour.

Requirements

• Current licensure in a clinical discipline as a Nurse (RN, LPN, or LVN) or Respiratory Therapist, or a current social work license/certification as required by state guidelines.
• Previous RN, LPN, RT, SW, or Case Manager experience in an inpatient hospital setting caring for critical-care or acute-care patients, such as ICU, step-down, med-surg, or ventilator patients.
• Adequate experience in acute medical case management and confidence managing and directing plans of care for chronically critically ill populations.
• Availability to work at least two shifts per month on an as-needed basis; shifts are scheduled on weekdays, approximately 8 a.m. to 5 p.m.

Nice To Haves

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

Responsibilities

• Develop and implement safe, timely, patient-specific discharge plans.
• Perform utilization-criteria reviews and comply with facility-wide Utilization Management policies and procedures.
• Manage resources and promote cost-conscious care within the patient’s plan of care.
• Build relationships and coordinate with payor sources to support appropriate reimbursement for hospital services.
• Coordinate Utilization Review compliance with Quality Management to meet licensure and accreditation requirements.
• Maintain fiscal responsibilities and identify and negotiate available reimbursement to maximize insurance-benefit coverage for patients.
• Review insurance verification forms to minimize risk.
• Facilitate multidisciplinary team meetings with physicians, nurses, respiratory therapists, and rehabilitation therapists.
• Manage treatment plans and complete medical-record documentation.
• Provide social work services as necessary, consistent with state guidelines.

Benefits

• Extensive orientation program.
• Potential advancement to full-time opportunities.
• Benefits supporting financial, work/life, and emotional well-being of employees and their family members.
• 401(k) eligibility for part-time/per-diem employees upon reaching 1,000 hours within their first anniversary or subsequent calendar year.
• Employee assistance program for part-time employees.

What This Job Offers

• Job Type: Part-time
• Education Level: No Education Listed