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    Market Case Manager - Pittsburgh, United States - Select Specialty Hospital - Pittsburgh UPMC

    Select Specialty Hospital - Pittsburgh UPMC
    Select Specialty Hospital - Pittsburgh UPMC Pittsburgh, United States

    6 days ago

    Default job background
    Part time
    Description
    Overview:
    Critical Illness Recovery Hospital

    Market Case Manager (Part Time)


    • Travel To Select Specialty Hospitals:
      Pittsburgh, McKeesport, and Natrona Heights
    • 20 Hours A Week

    Requires a current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state guidelines).

    Previous experience in critical care setting required.

    Previous discharge planning experience highly preferred.



    SHIFT:
    *Availability to work 20 hours a week - shifts would be scheduled on weekdays, during daylight hours.

    At Select Specialty Hospitals and Regency Hospitals, a division of Select Medical, we care for chronically and critically ill or post-ICU patients who require extended hospital care.

    Select Medical employs over 48,000 people across the country and provides quality care to approximately 70,000 patients each and every day across our four divisions.

    Our mission is to provide an exceptional patient care experience that promotes healing and recovery in a compassionate environment.

    Each employee plays a vital role in doing that by living our cultural behaviors - celebrating success, owning the future, being patient-centered, creating change, thinking first and building trust.

    Are you resourceful in overcoming obstacles? Are you a results-oriented team player? If you answered 'yes', consider an opportunity with us


    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.


    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.

    You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.

    Develops and implements a patient specific, safe and timely discharge plan.
    Performs verification of utilization criteria reviews.

    Builds 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 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:

    How you will be successful in this environment:
    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 discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per state guidelines
    Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients

    Preferred qualifications that will make you successful:
    Specific experience in Care Management and Discharge Planning is preferred.
    Working knowledge of the insurance industry and government reimbursement.
    *Availability to work 20 hours a week - shifts would be scheduled on weekdays, during daylight hours.

    Additional Data:


    Select Medical strives to provide our employees with work-life balance, as we understand that happy employees have both fulfilling careers and fulfilling lives beyond our doors.

    We'd love for you to join the team


    Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer.

    Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.

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