Case Manager

Encompass Health • Plano, TX

9d

About The Position

The Case Manager coordinates patient care and resources from admission through post-discharge, serving as a link between rehabilitation care and patient outcomes. The role uses clinical expertise to guide interdisciplinary plan-of-care decisions, with treatment plans based on patient needs and preferences. The Case Manager helps plan and execute the patient’s discharge, monitors the patient experience, and supports timely access to resources and post-discharge services.

The Case Manager facilitates weekly team conferences and coordinates treatment-plan modifications, completes required case-management documentation, reviews reports and indicators, and participates in utilization review and Acute Care Transfer meetings. The position also includes educating patients and families, establishing communication plans, arranging family conferences as needed, ensuring accurate patient-record information, and participating in the case-management on-call schedule as needed.

The role requires a professional who can independently complete assessments within the scope of their discipline and hold an active state license when required. Candidates must meet eligibility requirements for CCM® or ACM™ certification upon entry or within two years; certification is required or must be obtained within two years of placement in the Case Manager II position. Education requirements vary by discipline: nursing candidates need at least an Associate Degree in Nursing, while other eligible licensed or certified healthcare professionals need at least a bachelor’s degree.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the individual’s discipline (for example, 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 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.
• Nursing candidates must have a minimum of 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.
• Other eligible licensed or certified healthcare professionals must have a minimum of a bachelor’s degree.

Nice To Haves

• BSN preferred for nursing candidates.
• Graduate degree preferred for other eligible licensed or certified healthcare professionals.
• Two years of rehabilitation experience 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 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 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 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 and appropriate referrals, with documentation, 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