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.
Facilitate multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists
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.
Stresses Payor/Referral satisfaction. Effectively interacts with patients, families, and visitors to enhance guest relations. Represents the facility in all contacts with other health professionals and the general public in a manner which enhances the facility’s reputation. Meets payor requirements by assuring all insurance certifications are timely. Assures payor/referral satisfaction with Case Management to promote repeat business. Assures team is notified immediately of payor requirements.
Registered Nurse (RN) preferred
Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations
Minimum three (3) years of medical case management or health care social work
Passion for providing superior quality of care and excellent organizational and communication skills
Working knowledge of the insurance industry and government reimbursement
About Select Specialty Hospital Daytona Beach
Select Specialty Hospital is a Long Term Care Acute Hospital where we care for patients who require an extended stay in a specialty hospital setting before being discharged home or transferred to the next level of care such as assisted living or other.