Select Specialty Hospital
Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital, Tallahassee, Florida, us, 32318
Case Manager / PRN (RN / RT / SW / LPN)
Overview: The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. Reports to the Director of Case Management and provides social work services per state guidelines. Requires current licensure in a clinical discipline (Nurse or Respiratory Therapist) OR Social Work SW/MSW per state guidelines. Previous experience in a critical care setting and discharge planning highly preferred. Availability to work at least 2 shifts per month on an as-needed basis; shifts are weekdays roughly 8:00 a.m.–5:00 p.m. Responsibilities
Develops and implements a patient-specific, safe and timely discharge plan. Performs verification of utilization criteria reviews. Builds relationships with payor sources to assure proper reimbursement and promote cost-aware care through resource management within the plan of care. Demonstrates compliance with facility-wide Utilization Management policies and procedures. Coordinates utilization review compliance with Quality Management to fulfill licensure and accrediting requirements. Maintains fiscal responsibilities; identifies and negotiates reimbursement to maximize insurance benefit coverage; reviews insurance verification forms to minimize risk. Facilitates multi-disciplinary team meetings with physicians, nurses, respiratory therapists and rehabilitation therapists. Qualifications
Current licensure in a clinical discipline (RN/LPN/LVN) or Respiratory Therapist OR current Social Work license per state guidelines. Experience in inpatient hospital setting dealing with critical care/acute care patients (ICU, step-down, med-surg, vents). Experience in acute medical case management and ability to manage and direct a plan of care for chronically critically ill populations. Preferred: experience in Care Management and Discharge Planning; working knowledge of insurance industry and government reimbursement. Availability to work at least 2 shifts per month on an as-needed basis (weekdays, ~8:00 a.m.–5:00 p.m.).
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Overview: The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. Reports to the Director of Case Management and provides social work services per state guidelines. Requires current licensure in a clinical discipline (Nurse or Respiratory Therapist) OR Social Work SW/MSW per state guidelines. Previous experience in a critical care setting and discharge planning highly preferred. Availability to work at least 2 shifts per month on an as-needed basis; shifts are weekdays roughly 8:00 a.m.–5:00 p.m. Responsibilities
Develops and implements a patient-specific, safe and timely discharge plan. Performs verification of utilization criteria reviews. Builds relationships with payor sources to assure proper reimbursement and promote cost-aware care through resource management within the plan of care. Demonstrates compliance with facility-wide Utilization Management policies and procedures. Coordinates utilization review compliance with Quality Management to fulfill licensure and accrediting requirements. Maintains fiscal responsibilities; identifies and negotiates reimbursement to maximize insurance benefit coverage; reviews insurance verification forms to minimize risk. Facilitates multi-disciplinary team meetings with physicians, nurses, respiratory therapists and rehabilitation therapists. Qualifications
Current licensure in a clinical discipline (RN/LPN/LVN) or Respiratory Therapist OR current Social Work license per state guidelines. Experience in inpatient hospital setting dealing with critical care/acute care patients (ICU, step-down, med-surg, vents). Experience in acute medical case management and ability to manage and direct a plan of care for chronically critically ill populations. Preferred: experience in Care Management and Discharge Planning; working knowledge of insurance industry and government reimbursement. Availability to work at least 2 shifts per month on an as-needed basis (weekdays, ~8:00 a.m.–5:00 p.m.).
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