Case Manager Inpt Rehab Unit

Wellstar Health System•Roswell, GA

2d•Onsite

About The Position

The Case Manager serves as the primary liaison between the patient, family, the rehab team, outside agencies, and their representatives. This role provides information about patient's progress, referrals, educational information, and adjustment counseling to patients and their families. The Case Manager also coordinates the discharge planning process, adhering to professional standards, codes of ethics, and system and department policies and procedures.

Requirements

Associates Nursing or Bachelors Nursing or Masters Social Work
CCM - Certified Case Manager or LCSW - Lic Clinical Social Worker GA or LMSW - Lic Master Social Worker GA or MSW - Master Social Worker or RN - Reg Nurse (Single State) or RN-COMPACT - RN - Multi-state Compact
Minimum 2 years experience in medical case management inpatient rehab
Demonstrates skills or experience in case management.
Strong computer skills required.
Good communication skills both verbal and written.
Excellent time management/organizational skills
Working knowledge of the precertification process
Working knowledge of medical terminology
Basic computer proficiency required
Demonstrated counseling skills
Knowledge of community resources, federal and local guidelines, funding resources
Understanding of adult and geriatric development and age appropriate care
Understanding of the effects of illness and disability and the impact on both patient and family.

Responsibilities

Reviews all new admissions for completeness to assure compliance with insurance, pre-certification and DME requirements.
Documents discharge issues in the chart at appropriate intervals for progress findings.
Communicates with the team regarding progress and/or insurance issues.
Communicates with insurance providers to obtain episodic authorization.
Coordinates team goals, the interdisciplinary team conference, and the family education process to assure a smooth flow of care until discharge.
Executes various documents with the patient and family as needed.
Care coordination and follow-up with patient, family, team, and physicians.
Monitors LOS efficiency and facilitates discharge plan process.
Enters necessary financial and precert information into CANOPY to ensure timely flow.
Works with physician and manager to resolve failed or denied patient approvals.
Communicates with insurance companies to assure appropriate coverage and claims management.
Works with families to assure appropriate resource identification, access, and utilization.
Communicates with AC and physicians to facilitate benefits and pre-cert information on insurance patients, internal and external referrals.
Serves as a resource for the interdisciplinary team regarding insurance compliance issues.
Communicates to all stakeholders regarding patient progress.
Meets with patients, families, team members, and outside case managers to review patient progress, prepare for timely discharge, and schedules the education process for patients and families.
Assures authorization for equipment as required by insurance; facilitates discharge prescription assurance.
Assures documentation meets regulatory standards.
Participates in chart audits as requested.
Works with IRF-PAI Coordinator, physician, and interdisciplinary team to assure regulatory and CARF compliance.
Performs other duties as assigned.
Complies with all Wellstar Health System policies, standards of work, and code of conduct.