Case Management, Certified Occupational Therapist Assistant (COTA), Documentation, Family Social Work, Healthcare, Insurance, Mentoring, Occupational Therapy, Patient Care, Pediatrics, People Management, Physical Therapy, Process Management, Regulatory Compliance, Rehabilitation Medicine, Set Goals, Social Work, Speech and Language Pathology, Student Loans, Time Management, Treatment Evaluation, Treatment Plan, Tuition Fees
LOCATION
St. Louis, MO
POSTED
16 days ago
Overview
SSM Cardinal Glennon Pediatric Therapy
SSM Health Physical Therapy
St. Louis, MO
Case Manager - Full-Time
Full-time (M-F 8am-5pm)*
Experience in insurance verification and pediatric social work strongly preferred.
The Pediatric Case Manager plays a critical role in coordinating care for children receiving Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) services. This position is responsible for managing insurance authorization processes while also providing family-centered support informed by a background in social work.
Key Responsibilities:
Coordinate and manage insurance authorization for PT, OT, and SLP services, including initial requests, reauthorizations, and appeals as needed
Collaborate with therapists, providers, and administrative teams to ensure timely submission of documentation required for payer approval
Monitor authorization status, track service utilization, and proactively address potential gaps in coverage
Serve as a liaison between families, providers, and insurance companies to promote continuity of care
Apply social work principles to assess family dynamics, identify barriers to care, and provide guidance or referrals for additional community resources
Support families in navigating complex healthcare and social systems, including addressing psychosocial challenges that may impact treatment adherence
Advocate for patients and families to ensure access to medically necessary services
Maintain accurate, timely documentation in compliance with regulatory and organizational standards
Generous benefits package including:
Company matching 401(k)
Multiple and affordable PPO benefits + HSA options
Generous Paid Time Off + Holidays + Extended Illness Days (EID)
Short and Long Term Disability
Personal and Family Medical Leave
Clinical Ladder Program
Excellent Orientation Program
New Grad Mentorship
Residency Programs
National Continuing Education courses (local and online)
Tuition Assistance
Student Loan Repayment Assistance
Productivity standards that allow for high quality patient care
We have been recognized numerous times by the St. Louis Post Dispatch as one of the "Top Workplaces" in St. Louis!
Responsibilities
Under general direction monitors and assesses patient plan of care from pre-admission to post- discharge.
As part of the treatment team assists patient/family in goal setting to maximize patient's independence in both home and community. Interacts with payers to obtain necessary authorizations for initiating and continuing care throughout admission to the program.
Qualifications
Preferred Professional Healthcare Degree in either
Social Work
Licensed PT, OT, COTA, SLP
One year medical rehab case management experience (preferred)
Additional Data
Equal Opportunity Employer including Disabled/Veterans
About the Company
S
Select Medical Corp
Superior quality and care. Compassion and Respect. Results oriented. Teamwork. Resourcefulness. These are the core values upon which Select Medical was built. Since its founding in 1996, Select Medical has passionately focused on providing superior, patient-centered care that improves quality of life.Co-founded by Rocco Ortenzio and Robert Ortenzio, Select Medical began as a regional provider of outpatient physical rehabilitation. Contract therapy was added to the company's specialized health care offerings in 1997, and was quickly followed by the introduction of long-term acute care in 1998. In 1999, Select Medical made one of its largest acquisitions by purchasing NovaCare Physical Rehabilitation and Occupational Health. In three years, Select Medical had grown from a small start-up into a diversified health care company with a national presence. This progressive yet responsible growth was one attribute that led to the company's recognition as one of the Best Managed Companies in America by Forbes magazine.