Case Management Director jobs in Lorain, OH

University Hospitals Avon Rehabilitation Hospital is proud to be recognized by Newsweek as one of America’s Best Rehabilitation Hospitals in 2023. A career at University Hospitals Avon Rehabilitation Hospital, an inpatient acute rehabilitation hospital operated jointly with Lifepoint Health and University Hospitals, is more than a job. It’s a chance to be a vital member of an interdisciplinary team caring for people in the Avon area who need continued care to recover completely. You have specialized skills and our patients in Avon need them! If you are an enthusiastic individual seeking an environment dedicated to superior patient care and an organization with a strong mission to serve our community, we invite you to apply!

Our Benefits:

• Number 4 Inpatient Rehabilitation Hospital in Ohio for 2023
• High Quality Patient Outcomes
• 80% of our patients go home
• 401(k) - with Company Match, even for PRN
  
• Career Growth Opportunities
• and more!

What you will do in this role:

• Provides assistance to the case management staff, including but not limited to, creating and sending referral packets, organizing admission and discharge patient records, making phone calls, obtaining signatures, or any other assistance needed determined by the CM team
• Assists the case management team by making necessary arrangements for post-discharge follow up care
• Forwards the necessary patient clinical information for all admission, concurrent, and retrospective insurance reviews to payers for the completion of medical necessity reviews
• Monitors, follow-up, documents, and tracks payer responses/requests of completed clinical reviews, including approvals, appeals, and denials, and communicates these to the appropriate personnel [hospital staff, physician, DCM, Case Manager, Clinical Denial Management, and Centralized Business Office (CBO)]
• Monitors and tracks the total hospital certified days of the patient for payers (commercial, managed care, and Medicaid) and communicates missing certifications to the Lead CM/DQ and Case Manager
• Performs other related duties as assigned

• College degree in healthcare related field preferred
• LPN or social work degree preferred but not required
• Minimum of 1 year hospital or post-acute healthcare experience with preference in case management or clinical department.  Proficient with WORD and EXCEL software, keyboard typing, and general office equipment

University Hospitals Avon Rehabilitation Hospital strives to maximize the health, function, and quality of life of those we serve through comprehensive physical medicine and rehabilitation programs. Our rehabilitation programs provide ongoing care and specialized treatment to patients throughout their recovery journey. We offer customized, intensive rehabilitation tailored to the individual needs of those recovering from stroke, brain injury, neurological conditions, trauma, spinal cord injury, amputation, and orthopedic injury. We are accredited by The Joint Commission and CARF-accredited for our Comprehensive Integrated Inpatient Rehabilitation Program and Stroke Specialty Program.