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

Select Specialty Hospital – Morgantown • Morgantown, WV

12d

About The Position

Select Specialty Hospital is a critical illness recovery hospital (LTACH) providing inpatient post-ICU services to chronically and critically ill patients who need extended healing and recovery. The Director of Case Management contributes clinical knowledge to the department’s operations and professional growth, including utilization review and resource management, discharge planning, treatment plan management, and financial management effectiveness. The role is full-time, 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 managing a case management department, or case management experience at Select Medical with demonstrated effective leadership skills.
• Internal candidates must have consistently achieved set objectives and be recommended by the hospital CEO.
• Previous case management or discharge-planning experience with medically complex patients in a hospital critical care setting.
• Supervisory experience.

Nice To Haves

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

Responsibilities

• Develop and implement patient-specific, safe, and timely discharge plans.
• Perform verification of utilization criteria reviews.
• Build relationships and coordinate with payor sources to ensure proper reimbursement for hospital services and promote cost-conscious care through resource management.
• Demonstrate compliance with facility-wide Utilization Management policies and procedures.
• Coordinate utilization review compliance with Quality Management to fulfill licensure and accreditation requirements.
• Maintain fiscal responsibilities and ensure the department identifies and negotiates the fullest possible 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 department’s overall functions and professional growth.

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: Director
• Education Level: No Education Listed