Case Manager - Rehabilitation - Lifepoint Health

Hannibal Regional Healthcare System • Hannibal, MO

2d • Onsite

About The Position

Lifepoint Rehabilitation is seeking a Case Manager for the inpatient rehabilitation/post-acute care unit at Hannibal Regional Hospital in Hannibal, Missouri. The role coordinates care management and resource utilization, supports service delivery and compliance with external review agencies, and provides comprehensive assessment, care planning, implementation, and evaluation based on individual patient needs. It integrates case management, utilization review and management, and discharge planning to improve patient management and satisfaction, continuity of care, and cost effectiveness.

The Case Manager works with patients, caregivers, physicians, nursing, therapy, ancillary departments, and other staff to develop and monitor treatment plans, address barriers to care and discharge, and coordinate safe discharge plans. The role also completes required documentation and assessments, supports utilization reviews and payer communications, and contributes to quality and performance-improvement activities. The unit is described as fast-paced, 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, time-management, and analytical skills, including the ability to interpret information and carry out duties independently.
• Cooperative approach and willingness to work as part of a team.
• 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 and content requirements, including the Individual Plan of Care (IPoC) in accordance with CMS guidelines.
• Schedule family conferences and communicate with caregivers after team conferences and as needed about patient progress, rehabilitation goals, the course of the stay, and discharge plans.
• Coordinate weekly patient care team conferences to develop, monitor, and refine treatment plans that support patient goals and outcomes.
• Review assigned case-mix groups (CMGs), help identify potentially missed comorbid conditions being treated during the stay, and communicate findings to the Health Information Management (HIM) team.
• Communicate with nursing, therapy, and ancillary departments to support proper utilization of services.
• If 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 review activities, including denials and appeals.
• Work with physicians to conduct peer review with a payer medical director when indicated.
• Provide clinical updates to insurance payers when due and document payer communications in Meditech.
• Coordinate discharge planning services and needs, such as home health, follow-up care, durable medical equipment, medical supplies, outpatient therapy, dialysis, skilled nursing, assisted living, hospice, and private-duty care.
• Coordinate patient care needs before discharge and ensure a safe, thorough discharge plan.
• Offer and document patient choice in accordance with CMS Conditions of Participation for Discharge Planning.
• Identify trends affecting quality, cost effectiveness, patient experience, and care delivery, and raise them for discussion and action at 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.
• Mental, physical, and financial 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