Case Manager

Encompass Health • North Charleston, SC

11d

About The Position

Encompass Health is seeking a Case Manager to coordinate patient care from admission through post-discharge and oversee interdisciplinary plan-of-care decisions. The role manages resources and connects clinical care with patient needs and preferences in an inpatient rehabilitation setting.

The Case Manager works with patients, families, and the interdisciplinary team to plan treatment and discharge, monitor the patient experience and care requirements, facilitate team conferences, maintain documentation, and coordinate referrals and resources. The position also participates in utilization review and an on-call schedule as needed.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the person's discipline, such as nursing, social work, occupational therapy, physical therapy, speech therapy, or rehabilitation counseling.
• Must hold an active license if licensure is required for the discipline in the state of practice.
• 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, an Associate Degree in Nursing and RN licensure are required; a diploma is accepted only in states where it is the minimum requirement for licensure or certification.
• For other eligible licensed or certified health care professionals, a bachelor's degree is required.

Nice To Haves

• A Bachelor of Science in Nursing is preferred for nursing candidates.
• A graduate degree is preferred for other eligible licensed or certified health care professionals.
• Two years of rehabilitation experience is 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, 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 timely, appropriate referrals to post-discharge providers and physicians, with documentation.
• Ensure discharge and payor-related information in patient records 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