Regional Resource Case Manager Full Time

Kindred Healthcare•Las Vegas, NV

12d•$54 - $79

About The Position

At ScionHealth, caregivers are encouraged to contribute their perspectives, meet challenges, and embrace curiosity as part of a culture centered on patients and teammates. The Regional Resource Case Manager serves as a case management subject matter expert, providing operational expertise across case management departments at multiple Kindred hospitals. The role coordinates patient care through collaboration and communication with Interdisciplinary Care Transitions (ICT) members and follows patients across the continuum of care. It supports optimum resource utilization, service delivery, and compliance with external review agencies through assessment, care planning, implementation, and evaluation of individual patient needs. The position integrates case management, utilization review and management, and discharge planning to support care quality, patient satisfaction, continuity, and cost effectiveness. It also partners with external customers, referral sources, and payors to coordinate discharge planning and advocate for patients and families. The position provides staff education and serves as a mentor and preceptor on resource utilization, discharge planning, and psychosocial aspects of healthcare delivery. It requires travel approximately 100% of the time. The pay range is $54.34–$79.49 per hour.

Requirements

Graduate of an accredited program.
Healthcare professional licensure as a Registered Nurse, Licensed Clinical Social Worker (LCSW), or Licensed Social Worker (LSW) if required by state regulations.
Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
Knowledge of Medicare benefits, insurance processes, and contracts.
Knowledge of accreditation standards and compliance requirements.
Adaptability and flexibility.
Critical-thinking, prioritization, and time-management skills.
Fluent in reading, writing, and speaking English.
Basic computer skills and working knowledge of Microsoft Office, word-processing, and spreadsheet software.
Excellent interpersonal, verbal, and written communication skills to obtain cooperation and collaboration from hospital leadership, physicians, payors, and other external customers.
Interpersonal skills for working and interacting with patients, families, and staff.
Regular attendance.
Ability to travel approximately 100% of the time.

Nice To Haves

Registered Nurse (RN), Bachelor of Science in Nursing (BSN), or Master of Social Work; alternatively, a Bachelor of Social Work with licensure as required by state regulations.
Certification in Case Management.
Two years of experience in a healthcare setting, preferably acute care or LTACH.
Prior experience in case management, utilization review, or discharge planning.

Responsibilities

Serve as a subject matter expert in daily patient-care coordination, facilitating the development, monitoring, and refinement of treatment plans.
Work with the Director of Case Management to support compliance with CMS, state, JCAHO, and company requirements, including documentation and records; participate in surveys and audits.
Coordinate clinical and psychosocial activities with the Interdisciplinary Team and physicians.
Monitor patient stays to support effective care coordination and efficient care facilitation.
Maintain current knowledge of reimbursement modalities, community resources, case management, and psychosocial and legal issues affecting patients and care providers.
Refer high-risk patients for additional support when appropriate.
Advocate for patients and foster collaboration that helps patients and families make informed decisions.
Apply knowledge of growth and development across the life span to provide age-appropriate care.
Participate in interdisciplinary rounds and conferences to review treatment goals, optimize resource use, and educate patients and families about post-hospital needs.
Collaborate with clinical staff to develop and execute plans of care and achieve goals.
Coordinate care planning across the continuum with the interdisciplinary team, physicians, patients, families, post-acute providers, payors, and others.
Conduct comprehensive, ongoing patient assessments to provide timely and safe discharge planning.
Develop and carry out comprehensive discharge plans using critical thinking.
Communicate and coordinate effectively with patients and families.
Conduct medical-necessity reviews for appropriate utilization of services from admission through discharge.
Promote effective and efficient utilization of clinical resources.
Complete timely and accurate clinical reviews and coordinate continued-stay authorization with payors.
Perform duties in accordance with the Company Code of Business Conduct, company policies and procedures, the Corporate Compliance Agreement, applicable laws, and professional standards.
Serve on hospital and division committees when requested.
Perform other related duties as assigned.
Provide staff education and serve as a mentor and preceptor regarding resource utilization, discharge planning, and psychosocial aspects of healthcare delivery.