Case Manager - Pediatrics

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