Case Manager

Encompass Health • Colorado Springs, CO

12d

About The Position

The Case Manager coordinates patient care from admission through post-discharge and oversees interdisciplinary plan-of-care decisions. The role manages resources, supports patient and family communication, and helps ensure care and discharge planning reflect each patient’s needs and preferences. Case Managers work with an interdisciplinary team, monitor patient experience and utilization, facilitate team and family conferences, and coordinate referrals and resources to support timely, appropriate discharge.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the individual’s discipline, such as nursing, social work, occupational therapy, physical therapy, speech therapy, 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.
• For nursing candidates, an Associate Degree in Nursing and RN licensure are required. A diploma is acceptable only in states where it meets the minimum licensure or certification requirement.

Nice To Haves

• BSN preferred for nursing candidates.
• For other eligible licensed or certified health care professionals, a graduate degree is preferred.
• 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 execution of 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 ordering and payment of orthotics and prosthetics.
• Make timely, 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