Registered Nurse (R)N-Pediatric Rehab Case Manager, Full-Time, Days

Prisma Health • SC

107d

About The Position

The position involves performing activities and duties related to preadmission assessment screening and admission of patients to the Pediatric Inpatient Rehabilitation Unit. The role serves as a Case Management resource for patients and family members, assessing patient progress with rehabilitation plans and collaborating with the Pediatric Inpatient Rehabilitation leadership and therapy team to enhance the rehabilitation process. The position also includes providing expert guidance on regulatory and compliance concerns for Case Management, performing discharge planning activities, and proactively identifying and resolving obstacles to patient rehabilitation while monitoring the documentation of patient medical records.

Requirements

• Bachelor's degree in nursing.
• Three (3) years of acute care nursing experience.
• One (1) year of acute care/case management experience preferred.
• Currently licensed RN in South Carolina.
• BLS certification.
• Valid driver's license and acceptable motor vehicle record.

Nice To Haves

• Knowledge of insurance and managed care principles and practices.
• Knowledge of regulations of agencies involved in program operation and resources for assessing regulations and third-party reimbursement.

Responsibilities

• Conduct insurance and pre-admission screenings and clinical assessments to ensure patients qualify for rehabilitation admission and insurance reimbursement.
• Facilitate the smooth transition of patients into the Pediatric Inpatient Rehabilitation Unit by coordinating transportation and receiving times.
• Educate patients, family members, referral sources, and external payers about the effective utilization of program services and available resources.
• Serve as a Case Management resource for patients and families regarding their rights and responsibilities.
• Assess patients' and families' psychosocial risk factors through evaluation of prior functioning levels and support systems.
• Perform discharge planning activities for patients with complex medical issues to ensure timely discharge and appropriate linkage with post-acute rehabilitation care providers.
• Address and resolve system problems impeding rehabilitation progress.
• Monitor patient progress and intervene as necessary to ensure high-quality, efficient, and cost-effective care.
• Partner with Pediatric Inpatient Rehabilitation Center leadership and marketing to promote rehabilitation services.
• Assist in the development, maintenance, evaluation, and interpretation of clinical data related to admissions and discharges.
• Attend and facilitate weekly Inpatient Pediatric Rehabilitation Case Conferences and Family meetings.
• Participate in compliance monitoring for the Commission on Accreditation of Rehabilitation Facilities and the Joint Commission.
• Provide expert guidance on regulatory and compliance concerns for Case Management and Utilization Management.
• Monitor medical record documentation for quality and accuracy.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees