Case Manager

Encompass Health • Augusta, GA

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 each patient’s recovery. The role works with an interdisciplinary team to guide treatment plans, oversee plan-of-care decisions, support discharge planning, and help ensure meaningful patient outcomes.

The Case Manager monitors patient experience and care appropriateness, facilitates weekly team conferences, coordinates treatment-plan changes, completes case-management documentation, and helps patients and families understand rehabilitation and the Case Manager’s role. The position also supports utilization review, monitors regulatory compliance, reviews case-management reports, and coordinates referrals and resources to avoid discharge delays. Participation in an on-call schedule may be required as needed.

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 of practice.
• Must meet eligibility requirements for CCM® or ACM™ certification upon entering 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, a minimum of an Associate Degree in Nursing and RN licensure are required; a diploma is acceptable only in states where it is the minimum requirement for licensure or certification.

Nice To Haves

• For nursing, a BSN is preferred.
• For other eligible licensed or certified health care professionals, a graduate degree is preferred; a bachelor’s degree is the minimum.
• 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, 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 a 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 promptly to avoid discharge delays or issues.
• Monitor compliance with regulations for orthotics and prosthetics ordering and payment.
• Make timely and appropriate referrals, including 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
• Career Level: Mid Level
• Education Level: Associate degree