Case Manager

About the role

Join Encompass Health as a Case Manager, where you will serve as a vital link between exceptional care and the transformative impact on each patient's journey. This role allows you to leverage your clinical expertise while contributing to the well-being of individuals in your community. Manage resources, coordinate patient care from admission to post-discharge, and oversee interdisciplinary plan-of-care decisions.

Responsibilities

• Work with interdisciplinary team, guiding treatment plans based on patient needs and preferences
• Coordinate with interdisciplinary team to establish tentative discharge plan and contingency plans
• Participate in planning for and the execution of patient discharge experience
• Monitor patient experience: quality/timeliness/service appropriateness/payors/expectations
• Facilitate team conferences weekly and coordinate all treatment plan modifications
• Complete case management addendums and all required documentation
• 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
• Meet with patient/family per Patient Arrival and Initial Visit Standard within 24 hours of admission
• 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
• Assist patient with timely procuring/planning of resources to avoid discharge delays or issues
• Monitor 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

License or Certification:

• 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

Benefits

• Affordable medical, dental, and vision plans for both full-time and part-time employees and their families
• Generous paid time off that accrues over time
• Opportunities for tuition reimbursement and continuous education
• Company-matching 401(k) and employee stock purchase plans
• Flexible spending and health savings accounts