Select Specialty Hospital
Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital, Wichita, Kansas, United States, 67232
Case Manager / PRN (RN / RT / SW / LPN)
Overview
Case Manager (PRN) with licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or Respiratory Therapist or Social Work SW/MSW (per state guidelines). Previous experience in a critical care setting and discharge planning is preferred.
Responsibilities
Develops and implements a patient-specific, safe and timely discharge plan.
Performs verification of utilization criteria reviews.
Builds relationships and coordinates with payor sources to ensure proper reimbursement for hospital-provided services and focuses on resource management within the plan of care.
Demonstrates compliance with facility-wide Utilization Management policies and procedures.
Coordinates UR compliance with Quality Management to ensure licensure and accrediting requirements are fulfilled.
Maintains fiscal responsibilities. Identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage; reviews insurance verification forms to minimize risk.
Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Qualifications
Minimum requirements:
Current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist OR current license/certification as Social Work per state guidelines.
Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients (e.g., ICU, step-down, med/surg, vents).
Adequate experience in an acute medical case management setting and the ability to manage and direct a plan of care for chronically critically ill populations.
Preferred qualifications:
Specific experience in Care Management and Discharge Planning is preferred.
Working knowledge of the insurance industry and government reimbursement.
Availability to work a minimum of 2 shifts per month on an "as needed" basis — shifts would be scheduled on weekdays, from approximately 8 a.m.–5 p.m.
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Responsibilities
Develops and implements a patient-specific, safe and timely discharge plan.
Performs verification of utilization criteria reviews.
Builds relationships and coordinates with payor sources to ensure proper reimbursement for hospital-provided services and focuses on resource management within the plan of care.
Demonstrates compliance with facility-wide Utilization Management policies and procedures.
Coordinates UR compliance with Quality Management to ensure licensure and accrediting requirements are fulfilled.
Maintains fiscal responsibilities. Identifies and negotiates the fullest possible reimbursement to maximize insurance benefit coverage; reviews insurance verification forms to minimize risk.
Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Qualifications
Minimum requirements:
Current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist OR current license/certification as Social Work per state guidelines.
Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients (e.g., ICU, step-down, med/surg, vents).
Adequate experience in an acute medical case management setting and the ability to manage and direct a plan of care for chronically critically ill populations.
Preferred qualifications:
Specific experience in Care Management and Discharge Planning is preferred.
Working knowledge of the insurance industry and government reimbursement.
Availability to work a minimum of 2 shifts per month on an "as needed" basis — shifts would be scheduled on weekdays, from approximately 8 a.m.–5 p.m.
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