Director of Case Management ( RN / RT / MSW / LPN )

Select Medical • Rochelle Park, NJ

7d • Onsite

About The Position

Select Specialty Hospital Critical Illness Recovery Hospital (LTACH) is seeking a Director of Case Management. This role is responsible for the overall functions and professional growth of the department, including utilization review, resource management, discharge planning, treatment plan management, and financial management effectiveness. The Director will develop and implement patient-specific discharge plans, perform utilization criteria reviews, coordinate with payor sources for reimbursement, and ensure compliance with facility-wide policies and procedures. This position plays a central role in providing compassionate, excellent care to chronic, critically ill patients who require extended healing and recovery.

Requirements

• Current licensure in a clinical or a related discipline.
• Minimum three (3) years of medical case management or similar experience.
• Two (2) years of experience in either (a) managing a case management department; or (b) case management at Select Medical with demonstrated effective leadership skills.
• Previous case mangement ( discharge planning ) experience with medically complex patients in a hospital critical care setting and supervisory experience.

Nice To Haves

• Current RN licensure preferred.
• Working knowledge of the insurance industry and government reimbursement.

Responsibilities

• Developing and implementing a patient-specific, safe and timely discharge plan.
• Performing verification of utilization criteria reviews.
• Building relationships and coordinating with payor sources in order to ensure proper reimbursement for hospital provided services and to promote cost attentive care via a focus on resource management.
• Demonstrating compliance with facility-wide Utilization Management policies and procedures.
• Coordinating UR compliance with Quality Management to ensure 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.

Benefits

• Sign On Bonus: $10,000
• 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: Manager