Case Manager RN, LMSW, LCSW Per Diem

Cornerstone Specialty Hospitals Shawnee - Shawnee, OK

Full-time

Shawnee, OK

About the position

The Case Manager RN, LMSW, LCSW Per Diem role is focused on coordinating and facilitating patient care through collaboration with the Interdisciplinary Care Transitions team. The position emphasizes effective communication, resource utilization, and compliance with external review agencies, ensuring that patients receive optimal care throughout their treatment journey. The Case Manager will provide ongoing support through comprehensive assessments, care planning, and evaluations to enhance patient management and satisfaction.

Responsibilities

• Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Monitors all areas of patients' stay for effective care coordination and efficient care facilitation.
• Remains current on reimbursement modalities, community resources, case management, psychosocial and legal issues affecting patients and providers.
• Refers high-risk patients who would benefit from additional support.
• Serves as a patient advocate to enhance collaborative relationships for informed decision-making.
• Demonstrates knowledge of growth and development principles to provide age-appropriate care.
• Participates in interdisciplinary patient care rounds to review treatment goals and optimize resource utilization.
• Coordinates with interdisciplinary care team, physicians, patients, families, and post-acute providers in care planning.
• Conducts comprehensive assessments for timely and safe discharge planning.
• Utilizes critical thinking to develop and execute effective discharge planning.
• Conducts medical necessity reviews for appropriate service utilization from admission through discharge.

Requirements

• Graduate of an accredited program required: RN, BSN preferred, or Master of Social Work with licensure, or Bachelor of Social Work with licensure as required by state regulations.
• Healthcare professional licensure required as Registered Nurse or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.
• Certification in Case Management preferred.
• Two years of experience in a healthcare setting preferred.
• Prior experience in case management, utilization review, or discharge planning preferred.
• Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
• Knowledge of Medicare benefits and insurance processes and contracts.
• Knowledge of accreditation standards and compliance requirements.

Nice-to-haves

• Certification in Case Management preferred.