Case Manager

Encompass Health • Lutz, FL

6d

About The Position

The Case Manager at Encompass Health coordinates patient care and manages resources from admission through post-discharge. The role works with an interdisciplinary team to guide treatment planning based on patient needs and preferences, oversee plan-of-care decisions, and help patients and families navigate rehabilitation and discharge. The Case Manager also monitors patient experience, supports utilization review, maintains accurate documentation, and helps ensure timely access to resources and post-discharge services.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the applicable discipline, such as nursing, social work, occupational therapy, physical therapy, speech therapy, or rehabilitation counseling.
• If licensure is required for the discipline in the state, must hold an active license.
• Must meet eligibility requirements for CCM® or ACM™ certification upon entering 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: minimum Associate Degree in Nursing and RN licensure; a BSN is preferred. A diploma is acceptable only in states where it meets the minimum requirement for licensure or certification.
• For other eligible licensed or certified health care professionals: minimum bachelor's degree; a graduate degree is preferred.

Nice To Haves

• Two years of rehabilitation experience preferred.
• BSN preferred for nursing candidates.
• Graduate degree preferred for other eligible licensed or certified health care professionals.

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 carrying out 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 and 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 (ACT) meetings to identify trends and collaboratively reduce ACTs.
• Meet with patients and families 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 for 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 to post-discharge providers and physicians, with documentation.
• Ensure the accuracy of discharge and payor-related information in patient records.
• 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
• Education Level: Associate degree