Director of Case Management ( RN / RT / MSW / LPN )
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Select Specialty Hospital - Oakland
Pontiac, MI, US
Summary
The Director of Case Management oversees utilization review, resource management, and discharge planning to ensure high-quality patient care and financial effectiveness. They coordinate with multi-disciplinary teams and payor sources to optimize reimbursement and maintain compliance with facility policies.
Job Description
Overview
Select Specialty Hospital
Critical Illness Recovery Hospital (LTACH)
Director of Case Management
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 mangement ( discharge planning ) experience with medically complex patients in a hospital critical care setting and supervisory experience.
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.
Responsibilities
We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.
As the Director of Case Management, you will use your clinical knowledge and contribute to the overall functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan management and financial management effectiveness.
- 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.
Qualifications
We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.
Minimum requirements:
- 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).
Preferred qualifications that will make you successful:
- Current RN licensure preferred.
- Working knowledge of the insurance industry and government reimbursement.
Additional Data
General Benefits Full-time
- Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
- Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
- Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
- Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
- Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care
Equal opportunity employer, including disabled veterans
Part of the Select Medical family of brands, Select Specialty Hospitals treat the most critical and complex medical and surgical conditions. Select Specialty Hospitals offer a variety of programs and services to match the patient's acuity and individual needs. The physicians, along with our nurses and therapists, work closely together to improve the physical, emotional and functional wellness of our patients.
Select Medical provides equal employment [and affirmative action] opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.
Company size
10,001+ employees
Industry
Hospitals and Health Care
Org type
Privately Held
Headquarters
Mechanicsburg, PA
Part of the Select Medical family of brands, Select Specialty Hospitals treat the most critical and complex medical and surgical conditions. Select Specialty Hospitals offer a variety of programs and services to match the patient's acuity and individual needs. The physicians, along with our nurses and therapists, work closely together to improve the physical, emotional and functional wellness of our patients.
Select Medical provides equal employment [and affirmative action] opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.
Company size
10,001+ employees
Industry
Hospitals and Health Care
Org type
Privately Held
Headquarters
Mechanicsburg, PA