Overview:California Rehabilitation Institute*A Joint Venture with Select Medical & UCLA Health and Cedars-Sinai *Los Angeles, CACase Manager Per DiemBenefits of becoming a Case Manager with us:* Manageable case loads* Impact on patient’s recovery process and quality of life* High success rate of patients being discharged home* Competitive rates* Team-oriented culture* A network of over 50, 000 employees nationwide with advancement and relocation opportunities* Comprehensive benefits package for Full-time employees (including medical, dental, vision, 401k, life insurance, short and long term disability, and tuition assistance)Responsibilities:Position SummaryThe Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans.
The Case Manager, assesses the social work needs of the patient and provides social work intervention as part of the discharge planning process.
The primary job functions in Case Management include: Clinical Interventions/Discharge and Care Planning Management; Fiscal Management;and Payer/Referral Management.Specific Duties* Clinical Interventions/Discharge and Care Planning Management: Responsible for functioning as the liaison among all parties involved with the patient both within the hospital and in the community as it relates to the development and implementation of a safe and appropriate discharge plan.
The Case Manager participates as part of the interdisciplinary team developing, implementing, reviewing and revising the interdisciplinary plan of care.* Fiscal Management: Assures responsiveness to payer systems by maintaining ongoing communication and serving as the primary contact for all external payer sources, in turn generating revenue, enhancing reimbursement, minimizing financial risk and assuring payment for the hospital.
Maintains a thorough understanding of insurance coverage and benefits, providing interpretation to patients/families of their insurance and providing patient advocacy as needed.* Payer/Referral Management: Identifies and fulfills the requirements and needs of payer and referral sources, overseeing negotiations of continued stay rationale, length of stays, and appeals process.
Initiates activities to develop positive business relationships with payers and referral sources in order to promote repeat business and represent the hospital as a quality institution.* Carries a patient caseload.* Coordinates with other departments, i.E.
Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management outcomes for the patient.* Is responsible for developing and maintaining effective interdisciplinary working relationships with other clinical treatment team members, i.E.: medical, psychology, nursing, therapy, therapeutic recreation, vocational and dietary, in order to assure clinical outcomes that are appropriate, cost-effective, and beneficial to the patientQualifications:Minimum Qualifications Social Work background* Bachelor’s Degree in Social Work required, Masters Degree in Social Work preferred* Current and valid state licensure in Social Work required LCSWMinimum Qualifications RN background* Current state licensure as a Registered Nurse required* Previous experience in case management or related area requiredPrevious Experience Social Work or RN* BSN in nursing preferred.* CCM Certification Preferred.Additional Data:Overview of Select Medical Inpatient Rehabilitation HospitalsSelect Medical’s Inpatient Rehabilitation Hospitals provide advanced treatment and comprehensive care to best address the medical, physical, emotional and vocational challenges for individuals with:* Brain Injury* Spinal Cord Injury* Stroke* Amputation* Neurological Disorders* Orthopedic Conditions* Multiple Traumas**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.