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

Select Specialty Hospital - Springfield • Springfield, MO

23h • 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

• Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience.
• Previous case mangement ( discharge planning ) experience with medically complex patients in a hospital critical care setting and supervisory experience.
• 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. (Internal candidate must have consistently achieved set objectives and must be recommended by the hospital CEO).

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

• Generous PTO and Paid Sick Time for full-time team members
• Comprehensive medical/RX, health, vision, employee assistance program (EAP) 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: Manager