Case Manager

Encompass Health • Plano, TX

8d

About The Position

The Case Manager at Encompass Health is a vital link between exceptional rehabilitation care and each patient’s recovery journey. The role manages resources, coordinates patient care from admission through post-discharge, and oversees interdisciplinary plan-of-care decisions. The Case Manager works with patients, families, and an interdisciplinary team to support patient-centered treatment and timely, appropriate discharge planning.

The position monitors patient experience, coordinates treatment-plan changes, facilitates team and family conferences, completes required documentation, and supports utilization review. It also involves educating patients and families, arranging referrals and post-discharge resources, maintaining accurate patient and payor records, and helping ensure compliance with applicable regulations, company policies, and department procedures.

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 the discipline requires licensure 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.
• Nursing candidates must have at least an Associate Degree in Nursing and RN licensure; a BSN is preferred. A diploma is acceptable only in states where it is the minimum requirement for licensure or certification.
• Other eligible licensed or certified health care professionals must have at least a bachelor’s degree; a graduate degree is preferred.

Nice To Haves

• Two years of rehabilitation experience.
• BSN for nursing candidates.
• Graduate degree 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 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 collaborate on reducing transfers.
• 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 resources in a timely manner to avoid discharge delays or issues.
• Monitor compliance with regulations for ordering and payment of orthotics and prosthetics.
• Make timely and appropriate referrals, documenting referrals 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 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