Select Specialty/Regency Hospital
Case Manager (per diem)
Use your problem solving skills everyday while thriving in a fast-paced, challenging, and rewarding environment. You will be a vital role in managing and directing a patient focused clinical plan of care developed and implemented by a team of professionals that improves quality of life and leads to a safe and timely discharge.
- Develop and implement a patient specific, safe and timely discharge plan
- Perform verification of utilization criteria reviews
- Build relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus 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 assure all licensure and accrediting requirements are fulfilled
- Maintains fiscal responsibilities. Assures department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification form to minimize risk.
- Facilitate multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists
- Registered Nurse (RN) preferred
- Adequate experience (2-3 years) in an acute hospital / medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations
- Experience in care management, discharge planning, and utilization review
- Working knowledge of the insurance industry and government reimbursement
- Passion for providing superior quality of care and excellent organizational and communication skills
- Flexibility to provide coverage on an as needed basis, shifts would be Monday-Friday between 8am-5pm
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