Case Manager

Encompass Health • Wildwood, FL

3d

About The Position

Encompass Health is seeking a Case Manager to coordinate patient care from admission through post-discharge and connect exceptional rehabilitation care with each patient's needs. The Case Manager manages resources, oversees interdisciplinary plan-of-care decisions, and helps ensure that patient preferences, quality of care, and discharge needs are addressed. The role includes working with patients and families, coordinating treatment and discharge plans, monitoring patient experience and utilization, and maintaining required documentation and regulatory compliance. Candidates should have a BSW or MSW, or meet the listed qualifications for another eligible licensed or certified healthcare discipline.

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.
• If licensure is required for the discipline in the state, must hold an active license.
• Must meet eligibility requirements for CCM® or ACM™ certification upon entering 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, must have at least an Associate Degree in Nursing and RN licensure; a BSN is preferred. A diploma is acceptable only in states where it meets the minimum licensing or certification requirement.
• For other eligible licensed or certified healthcare professionals, must have at least a bachelor's degree.

Nice To Haves

• BSW or MSW.
• Graduate degree for eligible licensed or certified healthcare professionals outside nursing.
• Two years of rehabilitation experience.

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, 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 the patient and family 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 promptly to avoid discharge delays or issues.
• Monitor compliance with regulations for ordering and payment of orthotics and prosthetics.
• Make timely and appropriate referrals, with documentation, to post-discharge providers and physicians.
• 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