Case Manager ( RN / RT / SW / LPN )

Regency Hospital - Cleveland East • Warrensville Heights, OH

2d • $73,000 - $100,000 • Onsite

About The Position

Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives – and our team plays a central role in providing compassionate, excellent care every step of the way.

Requirements

• 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
• 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)

Nice To Haves

• Previous discharge planning experience preferred.
• Specific experience in Care Management and Discharge Planning is preferred.
• Working knowledge of the insurance industry and government reimbursement.

Responsibilities

• Develops and implements a patient specific, safe and timely discharge plan.
• Performs verification of utilization criteria reviews.
• Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
• Demonstrates compliance with facility-wide Utilization Management policies and procedures.
• Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
• Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
• Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
• Completing medical record documentation.
• Provide social work services, as necessary, per state guidelines.

Benefits

• Extensive and thorough orientation program
• Generous PTO and Paid Sick Time
• Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings
• Company-matching 401(k) retirement plan
• Life and disability protection

What This Job Offers

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