Select Specialty Hospital
Director of Case Management ( RN / RT / MSW / LPN )
Select Specialty Hospital, Phoenix, Arizona, United States, 85003
Director of Case Management (RN/RT/MSW/LPN)
Select Specialty Hospital, Critical Illness Recovery Hospital (LTACH)
Full Time: Monday – Friday 8‑5pm
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 management (discharge planning) experience with medically complex patients in a hospital critical care setting and supervisory experience.
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 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.
Maintaining fiscal responsibilities; assuring the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviewing insurance verification forms to minimize risk.
Facilitating multi‑disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Minimum Requirements
Current licensure in a clinical or 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).
Preferred Qualifications
Current RN licensure preferred.
Working knowledge of the insurance industry and government reimbursement.
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Full Time: Monday – Friday 8‑5pm
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 management (discharge planning) experience with medically complex patients in a hospital critical care setting and supervisory experience.
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 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.
Maintaining fiscal responsibilities; assuring the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviewing insurance verification forms to minimize risk.
Facilitating multi‑disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Minimum Requirements
Current licensure in a clinical or 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).
Preferred Qualifications
Current RN licensure preferred.
Working knowledge of the insurance industry and government reimbursement.
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