Case Manager

NeuLife•Mt Dora, FL

12d

About The Position

Neulife Rehabilitation of Florida is seeking a skilled, compassionate, and highly organized Case Manager for its Mt. Dora location. The organization provides post-acute rehabilitation and residential services to individuals with traumatic brain injuries, acquired brain injuries, spinal cord injuries, and other neurological disorders. The Case Manager coordinates resident care, manages insurance authorizations, facilitates discharge planning, and helps ensure residents have the services and resources needed to support their rehabilitation goals. The role involves assessing residents’ needs and goals, developing and monitoring individualized case management plans, coordinating healthcare and rehabilitation services, collaborating with interdisciplinary partners, and advocating for residents and families. It also includes obtaining and monitoring insurance authorizations, supporting utilization management and appeals, coordinating safe discharges and post-discharge services, and maintaining accurate documentation in compliance with facility policies, insurance requirements, and applicable regulatory standards.

Requirements

Previous experience in case management, healthcare, rehabilitation, or a related setting.
Knowledge of healthcare insurance processes, managed care, and medical necessity requirements.
Familiarity with community resources and post-acute care services.
Excellent written and verbal communication skills.
Strong organizational skills and attention to detail.
Ability to manage multiple priorities and meet deadlines in a fast-paced healthcare environment.
Ability to work independently while collaborating effectively with an interdisciplinary team.
Compassionate, resident-focused approach with strong advocacy skills.

Nice To Haves

Experience with insurance authorizations, utilization management, and discharge planning is strongly preferred.

Responsibilities

Conduct assessments and evaluations to identify residents’ needs, goals, and appropriate services.
Develop, implement, and monitor individualized treatment and case management plans.
Coordinate and oversee healthcare, rehabilitation, and supportive services.
Collaborate with physicians, nursing staff, therapists, insurance representatives, families, and external service providers.
Advocate for residents’ needs, rights, and access to appropriate services.
Monitor resident progress and coordinate interventions to address barriers to care.
Participate in interdisciplinary team meetings and care planning conferences.
Coordinate initial, continued-stay, and ongoing insurance authorizations for rehabilitation services.
Submit clinical documentation and supporting information to insurance companies to obtain and maintain service authorizations.
Monitor authorization dates, benefit limitations, and insurance coverage to prevent interruptions in care.
Communicate with insurance case managers, utilization review departments, and managed care organizations.
Assist with appeals and additional clinical documentation requests when necessary.
Monitor approved lengths of stay and communicate authorization concerns to the interdisciplinary team.
Initiate and coordinate discharge planning based on residents’ needs and rehabilitation progress.
Work with residents, families, caregivers, and community providers to develop safe and appropriate discharge plans.
Identify and coordinate post-discharge services, equipment, resources, and community support.
Facilitate transitions to home, assisted living, skilled nursing, or other appropriate care settings.
Ensure documentation, referrals, and follow-up arrangements are completed before discharge.
Address discharge barriers and collaborate with the interdisciplinary team to develop solutions.
Maintain accurate, timely, and comprehensive case management documentation.
Ensure compliance with facility policies, insurance requirements, and applicable regulatory standards.
Track authorizations, discharge plans, resident progress, and other case management activities.
Maintain effective communication with residents, families, healthcare professionals, and external agencies.