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.
• Aid 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

• 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.
• 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.