Case Manager / PRN ( RN / RT / SW / LPN )
Select Medical
- Omaha, NE
- Permanent
- Full-time
- 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.
- 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. (example: ICU, step-down, med surg, vents)
- Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations
- Specific experience in Care Management and Discharge Planning is preferred.
- Working knowledge of the insurance industry and government reimbursement.
- Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.