Case Manager PRN

Lifepoint Health•Mukilteo, WA

About The Position

Your experience matters! At Providence Swedish Rehabilitation Hospital, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but as a person. Providence Swedish Rehabilitation Hospital is a one-year-old, 40 bed, state of the art facility located in Lynnwood, WA. We offer: Specialized Rehab Programs: Tailored for individuals recovering from stroke, brain or spinal cord injury, orthopedic trauma, neurological conditions, or amputation. The goal is to restore independence and function. Modern Facilities: We have 40 private rooms, a state-of-the-art rehab gym, and dedicated spaces for dining and activities-all designed to create a comfortable, home-like environment. Therapy Intensity: Patients receive at least 15 hours of therapy per week, guided by a multidisciplinary team under the direction of a physiatrist (a doctor specializing in rehab medicine). Seamless Transition: Because the ARU is located within Kindred Hospital Sugar Land, patients can move directly from long-term acute care to rehabilitation without transferring to a different facility. Outdoor Mobility Areas: The hospital includes outdoor spaces where patients can practice walking and meet with family, supporting both physical and emotional recovery. As a Case Manager (CM) joining our team, you're embracing a vital mission dedicated to making communities healthier. Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve How you'll contribute: Coordinates management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management and discharge planning. Provides ongoing support and expertise through comprehensive assessment, care coordination, plan implementation and overall evaluation of individual patient needs while ensuring patient preferences. Serves as a patient advocate through resource utilization, discharge planning and addressing the holistic needs of the patient. The Case Manager (CM) is responsible for providing care coordination including needs assessment and identification of care options, communication with patients and families in an interdisciplinary environment consistent with the position's qualifications, professional practices and ethical standards. Promotes the hospital's mission, vision, and values.

Requirements

We prefer a current Registered Nurse or Social Work licensure or Healthcare professional licensure as Respiratory Therapist, Physical Therapist, Speech Language Pathologist or Occupational Therapist OR bachelor’s degree or Master’s Degree in Social Work or similar related field.
Minimum of 2 years social work or case management experience in an inpatient setting highly preferred; acute/rehabilitation hospital experience preferred.
Effective oral and written communication skills in English, additional languages preferred.
Basic computer skills in excel, word, outlook, power point, etc. required.
Must have good organizational skills, time management skills and analytical ability in order to interpret information and carry out duties independently
Must recognize and observe confidentiality principles.

Nice To Haves

We prefer a Certification in Case Management or Rehabilitation Nursing for example, Commission for Case Manager Certification (CCM); Association of Rehabilitation Nurses (ARN) certification, American Case Management Association (ACM) or Board Certification in CM by the ANCC e.g.: RN-BC

Responsibilities

Complete departmental orientation, initial and annual competencies.
Assist with departmental specific performance improvement initiatives collecting and reporting data
Consult other departmental staff to collaborate in patient care delivery; identify barriers to care and or discharge and develop solutions/resolution.
Complete documentation per workflow timeline and content requirements including completion of the Individual Plan of Care (IPoC) per CMS guidelines.
Schedule family conferences and/or communicate with caregiver following each team conference and more often as needed to keep patient and designated caregiver informed of progress and provides appropriate information related to goal achievement, course of rehabilitation stay, and plans for discharge.
Coordinate weekly patient care team conferences to facilitate development, monitoring and refinement of treatment plan to achieve identified patient goals and outcomes.
Review the patient's assigned CMG and helps the team identify any potential missed comorbid conditions that are actively being treated during the patient's stay. Communicates any findings to the HIM team.
Communicate effectively with nursing, therapy and other ancillary departments to ensure proper utilization.
Assist with concurrent and retrospective utilization review activities including denials and appeals. Work with physicians to conduct peer review with payer medical director.
Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech.
Coordinate discharge planning needs including but not limited to; home health services, physician follow up care, durable medical equipment, medical supplies, healthcare services, outpatient therapy, dialysis, skilled nursing care, assisted living care, hospice care, private duty care, etc. Responsible for coordinating all patient care needs prior to discharge ensuring a safe thorough discharge plan. Ensure patient choice is offered and documented as per CMS' Conditions of Participation for Discharge Planning.
Identify trends that impact the quality, cost effectiveness, patient experience and delivery of care services and bring to departmental leadership meetings for discussion and action.
Perform intake assessment on patient within 24 to 72 hours of admission, preferably within 48 hours.
Perform follow-up assessments.