Case Manager

Encompass Health • Lutz, FL

7d

About The Position

The Case Manager coordinates patient care from admission through post-discharge, manages resources, and oversees interdisciplinary plan-of-care decisions. The role helps guide treatment plans according to patient needs and preferences, supports a coordinated discharge experience, and monitors the quality, timeliness, and appropriateness of services. The Case Manager also collaborates with patients, families, payors, and post-discharge providers to support effective rehabilitation and transitions of care.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the relevant 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.
• Must meet eligibility requirements for CCM® or ACM™ certification upon entering the position or within two years of entry; 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 acceptable only in states where it is the minimum requirement for licensure or certification.
• For other eligible licensed or certified health care professionals, a minimum bachelor’s degree is required.

Nice To Haves

• For nursing, a BSN is preferred.
• For other eligible licensed or certified health care professionals, a graduate degree is preferred.
• Two years of rehabilitation experience is preferred.

Responsibilities

• Guide treatment plans with the interdisciplinary team 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, payor requirements, 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 in a timely manner to prevent discharge delays or issues.
• Monitor compliance with regulations for orthotics and prosthetics ordering and payment.
• 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 continuous education opportunities.
• Company-matching 401(k).
• Employee stock purchase plan.
• Flexible spending and health savings accounts.

What This Job Offers

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