Case Manager

Encompass Health • Las Vegas, NV

2d

About The Position

Encompass Health is hiring a Case Manager to coordinate patient care and resources from admission through post-discharge at its inpatient rehabilitation organization. The role contributes clinical expertise to interdisciplinary plan-of-care decisions and helps connect patients with appropriate care and resources throughout their rehabilitation journey.

The Case Manager works with patients, families, and the interdisciplinary team to develop and adjust treatment and discharge plans, monitor the patient experience, facilitate team and family conferences, and make referrals to post-discharge providers. The role also completes required assessments and documentation, supports utilization review, monitors regulatory and payer requirements, and participates in the case management on-call schedule as needed.

Requirements

• Must be qualified to independently complete an assessment within the scope of practice of the applicable 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 or within two years of entering the position; certification 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 accepted only in states where it meets the minimum requirement for licensure or certification.
• For other eligible licensed or certified health care professionals, a minimum of a bachelor's degree is required.

Nice To Haves

• BSN preferred for nursing candidates.
• Graduate degree preferred for other eligible licensed or certified health care 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 carrying out the patient discharge experience.
• Monitor patient experience, including quality, timeliness, service appropriateness, payer requirements, 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, payer requirements, and recertification needs.
• Attend Acute Care Transfer meetings to identify trends and collaborate on reducing 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 the patient and family about rehabilitation and the Case Manager role, and establish a communication plan.
• Schedule and facilitate family conferences as needed.
• Assist patients with timely procurement and planning of resources to avoid discharge delays or issues.
• Monitor compliance with regulations for ordering and payment of orthotics and prosthetics.
• Make timely and appropriate referrals, including documentation, to post-discharge providers and physicians.
• Ensure discharge and payer-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 accounts and health savings accounts.
• Supportive and inclusive work environment.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree