Case Manager

Encompass Health • Yuma, AZ

3d

About The Position

The Case Manager coordinates patient care and manages resources from admission through post-discharge, serving as a link between clinical care and patient outcomes. The role works with an interdisciplinary team to guide treatment plans, coordinate discharge planning, monitor the patient experience, and support patients and families throughout rehabilitation. The Case Manager also participates in utilization review, reviews case management reports, maintains compliance with applicable regulations and company policies, and may participate in an on-call schedule as needed.

The position requires a professional qualified to independently complete assessments within their discipline’s scope of practice. Depending on the discipline and state, an active license may be required. Candidates must meet eligibility requirements for CCM® or ACM™ certification upon entering the position or within two years; certification is required or must be obtained within two years of placement in the Case Manager II position.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of their 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 of practice.
• Must meet eligibility requirements for CCM® or ACM™ certification upon entry into 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 candidates, an Associate Degree in Nursing and RN licensure are required; a BSN is preferred. A diploma is accepted only in states where it is the minimum requirement for licensure or certification.
• Other eligible licensed or certified healthcare professionals must have at least a bachelor’s degree.

Nice To Haves

• Two years of rehabilitation experience preferred.
• For nursing candidates, a BSN is preferred.
• For eligible licensed or certified healthcare professionals other than nursing, a graduate degree 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 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 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 patients and families about rehabilitation and the Case Manager role, and establish a communication plan.
• Schedule and facilitate family conferences as needed.
• Help patients timely procure and plan resources to avoid discharge delays or issues.
• Monitor compliance with regulations for orthotics and prosthetics ordering and payment.
• Make appropriate and timely referrals to post-discharge providers and physicians, with documentation.
• 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