Case Manager Inpt Rehab Unit

Wellstar Health System•Roswell, GA

23h•Onsite

About The Position

At Wellstar, the mission is to enhance the health and well-being of every person served. Wellstar is a shining example of what's possible when professionals dedicate themselves to making a difference in the healthcare industry and in people's lives. The Social Worker/case manager serves as the primary liaison between the patient, family, the rehab team, outside agencies and their representatives. This role provides information about patient's progress, referrals and educational information and adjustment counseling to patients and their families, and coordinates the discharge planning process. The individual adheres to NASW professional standards, codes of ethics, system and department policies and procedures. Wellstar is one of Georgia’s largest and most integrated healthcare systems, with over 24,000 team members, nationally ranked and locally recognized for high-quality care and an inclusive culture, fostering a Great Place to Work.

Requirements

Associates Nursing or Bachelors Nursing or Masters Social Work
CCM - Certified Case Manager or LCSW - Lic Clinical Social Worker GA or LMSW - Lic Master Social Worker GA or MSW - Master Social Worker or RN - Reg Nurse (Single State) or RN-COMPACT - RN - Multi-state Compact (All certifications are required upon hire unless otherwise stated.)
Minimum 2 years experience in medical case management inpatient rehab
Demonstrates skills or experience in case management.
Strong computer skills required.
Good communication skills both verbal and written.
Excellent time management/organizational skills
Working knowledge of the precertification process
Working knowledge of medical terminology and basic computer proficiency required
Demonstrated counseling skills
Knowledge of community resources, federal and local guidelines, funding resources
Understanding of adult and geriatric development and age appropriate care
Understanding of the effects of illness and disability and the impact on both patient and family.

Responsibilities

Reviews all new admissions in EPIC and paper chart for completeness to assure compliance with insurance, pre-certification and DME requirements.
Documents discharge issues in the chart at appropriate intervals for progress findings.
Communicates with the team regarding progress and/or insurance issues.
Communication with insurance providers to obtain episodic authorization.
Coordinates team goals, the interdisciplinary team conference and the family education process to assure a smooth flow of care until discharge.
Executes various documents with the patient and family as needed.
Care coordination and follow-up with patient, family, team and physicians
Monitors LOS efficiency and facilitates discharge plan process
Enters necessary financial and precert information into CANOPY to ensure timely flow.
Works with physician and manager to resolve failed or denied patient approvals.
Communicates with insurance companies to assure appropriate coverage and claims management.
Works with families to assure appropriate resource identification, access and utilization
Communicates with AC and physicians to facilitate benefits and pre-cert information on insurance patients, internal and external referrals.
Serves as a resource for the interdisciplinary team, regarding insurance compliance issues.
Communicates to all stake holders regarding patient progress.
Meets with patients, families, team members and outside case managers to review patient progress, prepare for timely discharge and schedules the education process for patients and families.
Assures authorization for equipment as required by insurance; facilitates discharge prescription assurance.
Assures documentation meets regulatory standards
Participates in chart audits as requested
Works with IRF-PAI Coordinator, physician and interdisciplinary team to assure regulatory and CARF compliance.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.