Case Manager (per diem)

ID128926
Per Diem
3237 South 16th Street, 5th Floor
Milwaukee, WI 53215-4526
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Job Description

Select Specialty Hospital - West Allis & Saint Francis

 Case Manager (per diem/as needed)

 

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.

Responsibilities

  • 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

Qualifications

  • Registered Nurse (RN) or Licensed SW
  • 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
  • Ability to provide coverage both Milwaukee locations (St. Francis and West Allis) on an as needed basis

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