Case Manager

Encompass Health • Savannah, GA

2d

About The Position

The Case Manager manages resources and coordinates patient care from admission through post-discharge, overseeing interdisciplinary plan-of-care decisions. The role works with patients, families, and the interdisciplinary team to guide treatment plans, coordinate discharge planning, monitor the patient experience, and help ensure appropriate and timely access to resources and post-discharge care.

The Case Manager facilitates weekly team conferences and treatment plan modifications, completes required case-management documentation, monitors regulatory and payer requirements, and participates in utilization review and Acute Care Transfer meetings. The position also educates patients and families about rehabilitation and the Case Manager’s role, establishes communication plans, and supports a timely, well-coordinated discharge.

Requirements

• 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.
• Hold an active license if licensure is required for the discipline in the state of practice.
• Meet eligibility requirements for CCM® or ACM™ certification upon entry into the position or within two years of entry.
• Hold CCM® or ACM™ certification, or obtain it within two years of placement in the Case Manager II position.
• For nursing, possess at least an Associate Degree in Nursing and RN licensure. A diploma is acceptable only in states where it meets the minimum licensure or certification requirement.
• For other eligible licensed or certified health care professionals, possess at least a bachelor’s degree.

Nice To Haves

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

Responsibilities

• Guide treatment plans with the interdisciplinary team 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 the patient experience, including quality, timeliness, service appropriateness, payor matters, 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 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 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 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