Case Manager

Encompass Health • Parkersburg, WV

7d

About The Position

Encompass Health is seeking a Case Manager to coordinate patient care and resources from admission through post-discharge and oversee interdisciplinary plan-of-care decisions. The Case Manager uses clinical expertise to support patient well-being and help deliver meaningful rehabilitation outcomes.

The role works with an interdisciplinary team to guide treatment plans based on patient needs and preferences, coordinate discharge planning, monitor the patient experience, and ensure appropriate documentation and referrals. The Case Manager also supports utilization review, reviews case management reports and payor requirements, and participates in an on-call schedule as needed.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the individual's discipline, such as nursing, social work, occupational therapy, physical therapy, speech therapy, or rehabilitation counseling.
• Must hold an active state license if licensure is required for the individual's discipline.
• Must meet eligibility requirements for CCM® or ACM™ certification upon entry into the position or within two years of entry.
• CCM® or ACM™ certification is required, or must be obtained within two years of placement in the Case Manager II position.
• For nursing candidates: minimum Associate Degree in Nursing and RN licensure; BSN preferred. A diploma is acceptable only in states where it is the minimum requirement for licensure or certification.
• For other eligible licensed or certified health care professionals: minimum bachelor's degree.

Nice To Haves

• BSN preferred for nursing candidates.
• Graduate degree preferred for other eligible licensed or certified health care professionals.
• Two years of rehabilitation experience preferred.

Responsibilities

• Work with the interdisciplinary team to guide treatment plans based on patient needs and preferences.
• Coordinate with the interdisciplinary team to establish tentative discharge and contingency plans.
• Participate in planning and executing the patient discharge experience.
• Monitor patient experience, including quality, timeliness, service appropriateness, payors, and expectations.
• Facilitate weekly team conferences and coordinate treatment plan modifications.
• Complete case management addendums and required documentation.
• Maintain knowledge of regulations and standards, company policies and procedures, and department operations.
• Review and analyze case management reports, including Key Care Indicators, and plan appropriate actions.
• Understand commercial contract levels, exclusions, payor requirements, and recertification needs.
• Attend Acute Care Transfer meetings to identify trends and collaboratively reduce transfers.
• Meet with the patient and family within 24 hours of admission, in accordance with the Patient Arrival and Initial Visit Standard.
• Assess goals and complete the case management addendum within 48 hours of admission.
• Educate patients and families about rehabilitation and the Case Manager role, and establish a communication plan.
• Schedule and facilitate family conferences as needed.
• Help patients procure and plan resources in a timely manner to avoid discharge delays or issues.
• Monitor compliance with regulations for orthotics and prosthetics ordering and payment.
• Make appropriate and timely referrals to post-discharge providers and physicians, with documentation.
• Ensure discharge and payor-related information in the patient record is accurate.
• Participate in utilization review, including data collection, trend review, and resolution actions.
• Participate in the case management on-call schedule as needed.

Benefits

• Affordable medical, dental, and vision plans for full-time and part-time employees and their families.
• Paid time off that accrues over time.
• Tuition reimbursement and continuing education opportunities.
• Company-matching 401(k).
• Employee stock purchase plan.
• Flexible spending and health savings accounts.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree