Case Manager - Rehabilitation

Lifepoint Health • Ralls, MO

1d

About The Position

The Case Manager coordinates patient care management and ensures effective resource utilization, service delivery, and compliance with external review agencies. The role provides comprehensive assessment, care planning, plan implementation, and evaluation of individual patient needs. It integrates case management, utilization review and management, and discharge planning to improve care quality and patient satisfaction, promote continuity, and support cost effectiveness.

The Case Manager works with patients, caregivers, physicians, nursing, therapy, and ancillary departments to develop and monitor treatment plans, address barriers to care and discharge, and coordinate safe discharge services. The role also supports utilization review, payer communications, documentation, performance improvement, and facility case management activities. Hannibal Regional Hospital’s inpatient rehabilitation/post-acute care unit is described as a fast-paced environment with opportunities to learn and grow.

Requirements

• At least 2 years of social work or case management experience in an inpatient setting is highly preferred.
• Effective oral and written communication skills in English.
• Basic computer skills, including Excel, Word, Outlook, and PowerPoint.
• Good organizational and time-management skills and analytical ability to interpret information and perform duties independently.
• Cooperative, team-oriented approach.
• Ability to recognize and observe confidentiality principles.

Nice To Haves

• Certification in case management or rehabilitation nursing is preferred, such as CCM, ARN certification, ACM, or ANCC board certification in case management (RN-BC).
• Acute or rehabilitation hospital experience is preferred.
• Additional language skills are preferred.

Responsibilities

• Complete departmental orientation and initial and annual competencies.
• Assist with departmental performance improvement initiatives by collecting and reporting data as requested by the supervisor.
• Consult and collaborate with departmental staff to support patient care, identify barriers to care or discharge, and develop solutions.
• Complete documentation within required workflow timelines, including the Individual Plan of Care (IPoC) according to CMS guidelines.
• Schedule family conferences and communicate with caregivers after team conferences and as needed about patient progress, rehabilitation goals, and discharge plans.
• Coordinate weekly patient care team conferences to develop, monitor, and refine treatment plans and patient goals.
• Review assigned patient CMGs, help identify actively treated comorbid conditions that may have been missed, and communicate findings to the HIM team.
• Communicate with nursing, therapy, and ancillary departments to support appropriate resource utilization.
• When there is no Lead Case Manager, represent the facility on national case management conference calls and share new information with facility case managers.
• Assist with concurrent and retrospective utilization reviews, including denials and appeals, and work with physicians on payer medical director peer reviews when indicated.
• Provide clinical updates to insurance payers when due and document payer communications in Meditech.
• Coordinate discharge planning and patient care needs, including follow-up care, home health, durable medical equipment, supplies, outpatient therapy, and other post-discharge services; ensure a safe and thorough plan and document patient choice according to CMS Conditions of Participation for Discharge Planning.
• Identify trends affecting care quality, cost effectiveness, patient experience, and service delivery and bring them to departmental leadership meetings.
• Complete an intake assessment within 24 to 72 hours of admission, preferably within 48 hours.
• Complete follow-up assessments according to the Case Management Plan and/or hospital policy.
• Remain flexible and organized and function effectively in stressful situations.
• Perform other duties as assigned.

Benefits

• Multiple levels of medical, dental, and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, and hospital indemnity insurance.
• Short- and long-term disability coverage.
• Paid family leave and paid time off.
• Higher education and certification tuition assistance.
• Loan assistance.
• 401(k) retirement package with company match.
• Wellness programs, including free gym memberships, virtual care appointments, mental health services, and discount programs.
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed