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

Select Medical • Morgantown, WV

11d

About The Position

Select Specialty Hospital, a critical illness recovery hospital (LTACH), is seeking a full-time Director of Case Management. The hospital provides inpatient post-ICU services to chronically and critically ill patients who require extended healing and recovery. The Director contributes clinical knowledge to the department’s operations and professional development, overseeing utilization review and resource management, discharge planning, treatment plan management, and financial effectiveness. The schedule is Monday through Friday, 8 a.m. to 5 p.m.

Requirements

• Current licensure in a clinical or related discipline.
• At least three years of medical case management or similar experience.
• At least two years of experience either managing a case management department or working in case management at Select Medical with demonstrated effective leadership skills.
• For internal candidates: consistently achieved set objectives and received a recommendation from the hospital CEO.

Nice To Haves

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

Responsibilities

• Develop and implement patient-specific, safe, and timely discharge plans.
• Perform utilization criteria reviews.
• Build relationships and coordinate with payor sources to support appropriate reimbursement and cost-conscious resource management.
• Ensure compliance with facility-wide Utilization Management policies and procedures.
• Coordinate utilization review compliance with Quality Management to meet licensure and accreditation requirements.
• Maintain fiscal responsibilities.
• Ensure the department identifies and negotiates available reimbursement to maximize insurance benefit coverage for patients.
• Review insurance verification forms to minimize risk.
• Facilitate multidisciplinary team meetings involving physicians, nurses, respiratory therapists, and rehabilitation therapists.
• Contribute to the overall functions and professional growth of the department, including utilization review, resource management, discharge planning, treatment plan management, and financial management effectiveness.

Benefits

• Extensive orientation program.
• Generous PTO and paid sick time for full-time team members.
• Medical and 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: Director
• Education Level: No Education Listed