Case Manager

Kindred Hospital San Antonio • San Antonio, TX

387d

About The Position

The Case Manager II plays a crucial role in coordinating and facilitating patient care through effective collaboration with the Interdisciplinary Care Transitions (ICT) team. This position ensures optimal resource utilization, service delivery, and compliance with external review agencies while providing ongoing support through comprehensive assessment and care planning. The Case Manager II enhances patient management quality and satisfaction, promoting continuity of care and cost-effectiveness.

Requirements

• Graduate of an accredited program required: RN, BSN preferred OR Master of Social Work with licensure as required by state regulations; OR Bachelor of Social Work with licensure as required by state regulations.
• Healthcare professional licensure required as Registered Nurse or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.
• Certification in Case Management preferred.
• Two years of experience in a healthcare setting preferred.
• Prior experience in case management, utilization review, or discharge planning preferred.
• Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
• Knowledge of Medicare benefits and insurance processes and contracts.
• Knowledge of accreditation standards and compliance requirements.

Nice To Haves

• Certification in Case Management preferred.

Responsibilities

• Coordinate clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Monitor all areas of patients' stay for effective care coordination and efficient care facilitation.
• Remain current on reimbursement modalities, community resources, case management, psychosocial and legal issues affecting patients and providers.
• Refer high-risk patients who would benefit from additional support.
• Serve as a patient advocate and enhance collaborative relationships to maximize informed decision-making.
• Participate in interdisciplinary patient care rounds and/or conferences to review treatment goals and optimize resource utilization.
• Collaborate with clinical staff in developing and executing the plan of care and achieving goals.
• Coordinate with the interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in planning patient care throughout the continuum.
• Conduct comprehensive, ongoing assessments of patients for timely and safe discharge planning.
• Utilize critical thinking to develop and execute effective discharge planning.
• Conduct medical necessity reviews for appropriate utilization of services from admission through discharge.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Bachelor's degree