Case Manager

About the role

Join Encompass Health, a leading provider of rehabilitation care in the nation, where being a Case Manager positions you as a vital link between exceptional care and the transformative impact on each patient's journey.

Responsibilities

• Manage resources, coordinate patient care from admission to post-discharge, and oversee interdisciplinary plan-of-care decisions.
• Work with interdisciplinary team to establish tentative discharge plan and contingency plans.
• Participate in planning for and the execution of patient discharge experience.
• Maintain knowledge of regulations/standards, company policies/procedures, and department operations.
• Review/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 (ACT) meetings to identify trends and collaboratively reduce ACTs.
• Perform assessment of goals and complete case management addendum within 48 hours of admission.
• Educate patient/family on rehabilitation and Case Manager role; establish communication plan.
• Schedule and facilitate family conferences as needed.
• Avoid discharge delays or issues by assisting patient with timely procuring/planning of resources.
• Ensure compliance with regulations for orthotics and prosthetics ordering and payment.
• Make appropriate/timely referrals, including documentation to post discharge providers/physicians.
• Ensure accuracy of discharge and payor-related information in the patient record.
• Participate in utilization review process: data collection, trend review, and resolution actions.
• Participate in case management on-call schedule as needed.

Qualifications

• Licenses or Certifications: Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling). If licensure is required for one's discipline within the state, individual must hold an active license. Must meet eligibility requirements for CCM® or ACM™ certification upon entry into this position OR within two years of entry into the position. CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager II position.
• Minimum Qualifications: For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an Associate Degree. For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred. 2 years of rehabilitation experience preferred.