Case Manager

Encompass Health • Albuquerque, NM

7d

About The Position

Encompass Health is hiring a Case Manager to coordinate patient care and manage resources from admission through post-discharge. The Case Manager works with an interdisciplinary team to guide treatment plans according to patient needs and preferences, coordinate discharge planning, and oversee modifications to plans of care. The role supports patient and family communication, utilization review, regulatory compliance, and timely access to post-discharge resources and services.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the applicable discipline, such as RN, SW, OT, PT, ST, 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 entry or within two years of entering the position; certification 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 diploma is acceptable only in states where it is the minimum requirement for licensure or certification.

Nice To Haves

• For nursing candidates, 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

• 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, 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 orthotics and prosthetics ordering and payment.
• Make timely, appropriate referrals to post-discharge providers and physicians, with documentation.
• Ensure discharge and payor-related information in patient records 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