Case Manager - Rehab

About the role

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Delray Medical Center hospital, we are seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success. At Delray Medical Center, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work‑life balance.

Responsibilities

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self‑determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patients, families, and caregivers; Leads a population of patients by service line. The individual’s responsibilities include the following activities: accurate medical necessity screening and submission for Physician Advisor review; care coordination; transition planning assessment and reassessment; implementation or oversight of implementation of the transition plan; leading and facilitating multi‑disciplinary patient care conferences; managing concurrent disputes; making appropriate referrals to other departments; identifying and referring complex patients to Social Work Services; communicating with patients and families about the plan of care