case management leader

Medical City Healthcare

<p></p><div>This position is incentive eligible.<br>
<br>
<br>
<h5 class="jobSectionHeader"><b>**$10,000 Sign-On Bonus offered for Non-HCA Employees**</b></h5><h5 class="jobSectionHeader"><b>
Introduction</b></h5><p>
Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Director Case Management today with Medical City North Hills.</p><h5 class="jobSectionHeader"><b>
Benefits</b></h5><p>
Medical City North Hills offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:</p><ul><li>
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.</li><li>
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.</li><li>
Free counseling services and resources for emotional, physical and financial wellbeing<br>
</li><li>
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)<br>
</li><li>
Employee Stock Purchase Plan with 10% off HCA Healthcare stock<br>
</li><li>
Family support through fertility and family building benefits with Progyny and adoption assistance.<br>
</li><li>
Referral services for child, elder and pet care, home and auto repair, event planning and more<br>
</li><li>
Consumer discounts through Abenity and Consumer Discounts<br>
</li><li>
Retirement readiness, rollover assistance services and preferred banking partnerships<br>
</li><li>
Education assistance (tuition, student loan, certification support, dependent scholarships)<br>
</li><li>
Colleague recognition program<br>
</li><li>
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)<br>
</li><li>
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.</li></ul><p><br>
Learn more about Employee Benefits</p><p><b><i>
Note: Eligibility for benefits may vary by location.</i></b></p><p><br>
Come join our team as a Director Case Management. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!</p><h5 class="jobSectionHeader"><b>
Job Summary and Qualifications</b></h5><p></p><p>
</p><p>The Facility Case Management Director has the overall responsibility for managing and coordinating department activities. The Director ensures staff compliance with organizational policies and external regulatory agencies and takes leadership responsibility to coordinate the integration of the department's patient care and discharge planning processes with related hospital departments and external agencies to ensure continuity of care and optimal clinical resource utilization. The Director has oversight for all aspects of daily hospital case management operations and is accountable for achieving established outcomes through actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the department. This position requires an executive presence and candidates must possess excellent communication and presentation skills, proven motivational capabilities, and a demonstrated accomplishment record of delivering results and attaining goals. This position is a subject matter expert in case management that requires solid leadership, trust building, team building, as well as change management skills to ensure success of the department and case management initiatives. This position requires an individual who is a self-starter and has the ability to manage multiple priorities, work with minimal supervision on projects and activities, and demonstrate tact and diplomacy in situations of conflict and controversy. This individual must be able to adapt quickly to change and coordinate efforts across multiple stakeholders.</p><p>
Responsibilities:</p><p></p><ul><li>
Directs and evaluates departmental operations, including the case management model, staffing (skill mix and FTEs), use of information technologies, onboarding, and staff competencies to achieve performance and quality objectives.</li><li>
Allocates resources to effectively staff department and meet productivity and quality goals.</li><li>
Responsible for oversight of CM core functions and practice.</li><li>
Ensures the adherence to care coordination and discharge planning processes, ensuring timeliness, quality, and proper documentation.</li><li>
Works with the Facility CFO and Division CM Leader to achieve established goals and expectations.</li><li>
Assesses and improves the department&rsquo;s performance by evaluating operational processes, monitoring performance through analyzing data, and implementing sustainable performance improvement activities.</li><li>
Ensuring compliance with policies and SOP.</li><li>
Establish working relationships with key stakeholders to include CMO, CNO, ancillary service leaders, Ethics &amp; Compliance, and Legal.</li><li>
Performs other duties as assigned.</li><li>
Practices and adheres to the &ldquo;Code of Conduct&rdquo; and &ldquo;Mission and Value Statement.&rdquo;</li></ul><p></p><p>
What qualifications you will need:</p><p></p><ul><li><p>
Bachelor's degree, required</p></li><li>
Master's degree in Nursing, Health Administration, or Business Administration, preferred</li><li>
Either Registered Nurse (RN) licensure, Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW), required</li><li>
3+ years&rsquo; experience in overall acute care Hospital Case Management, preferred</li><li>
2+ years&rsquo; experience in case management leadership, preferred</li></ul><p></p><p>
&quot;The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual.&quot;- Dr. Thomas Frist, Sr.<br>
HCA Healthcare Co-Founder</p>
<p>If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Director Case Management opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. <b>Unlock the possibilities and apply today!</b></p><p><i>
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</i></p></div>

Director Case Management

INFIRMARY HEALTH

<div>Overview:
<p></p>
Qualifications:
<div><b>
Minimum Qualifications:</b></div><div></div><p><br>
3 of the most recent 5 years&rsquo; working with case management principles and practices in a leadership capacity</p><p></p><p><br>
One of the following:</p><ul><li>
Graduate of an accredited program of nursing and ACMA certified</li><li>
Bachelors&rsquo; degree in Social Work</li></ul><div></div><div><b><br>
Licensure, Registration, Certification:</b></div><div></div><p><br>
One of the following:</p><p>
One of the following:</p><ul><li>
Current Alabama RN license</li><li>
Current Multi State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama*</li><li>
Licensed in Alabama as a Licensed Graduate Social Worker (LGSW)</li><li>
Licensed in Alabama as a Licensed Bachelor Social Worker (LBSW)</li><li><i>Infirmary Health abides by the NLC requirements and guidelines for the state of Alabama</i></li></ul><p></p><div><br>
Must obtain American Case Management Association certification(ACMA) within 18 months of placement into position</div><div></div><div><b><br>
Desired Qualifications:</b></div><div></div><p><br>
BSN preferred</p><p></p><p><br>
Substantial background in management in an acute care setting</p><br>
<div></div>
Responsibilities:
<div>
Manages the overall operations of the case management function for Infirmary Health in order to provide services which meet IH's standards of quality, efficiency and desired outcomes.</div></div>

Case Management Manager

Sidra

<div><p><b>JOB SUMMARY
</b></p><p>The Clinical Nurse &ndash; Case Management is responsible for competently providing safe and effective care to Women and Children, with minimal supervision according to the comprehensive plan of care implemented by the by the Clinical Nurse Leader &ndash; Case Management. The Clinical Nurse &ndash; Case Management assesses care needs and liaises with the Clinical Nurse Leader &ndash; Case Management to provide the needed care. The Clinical Nurse &ndash; Case Management is responsible for ensuring that all duties are carried out to the highest possible standard. The Clinical Nurse &ndash; Case Management participates in the supervision and teaching of more junior and new members of staff within the unit. The Clinical Nurse &ndash; Case Management is professionally accountable to the Chief Nursing Officer.<br>
</p><p></p><p><b>DEPARTMENT/BRANCH PROFILE
</b></p><p>Case Management provides services to complex or high-risk patients receiving care at Sidra. Although case management is often initiated during the acute inpatient care phase, services are also provided in the outpatient settings to connect Sidra specialized clinics with primary care providers in the community. The case management team works collaboratively with the broader health care team to minimize inpatient length of stay by coordinating patient care across the continuum for patients and families with complex care transition needs. Clinical research focused on education, quality improvements and a culture of patient and family safety will be used to inform and guide best practice standards to assure safe, cost-effective and quality outcomes and contribute to Sidra&rsquo;s reputation as a high reliability organization.<br>
</p><p></p><p><b>WORK ENVIRONMENT THE ROLE OPERATES IN
</b></p><ul><li>Clinical roles are performed in an acute care hospital care setting.
</li><li>Physical effort required may include walking more than is typical due to the distances between hospital units.
</li><li>Physical risks normally associated with an acute care clinical environment.
</li><li>This is a clinical position.
</li><li>This role is patient facing.</li></ul></div>
<br><div><div>About US</div>
<div><div>Sidra Medicine a healthy population is essential to a strong, prosperous society, and throughout 2020, Sidra continued to provide uninterrupted comprehensive specialist healthcare services for children and young people; and exceptional maternity, gynecology, and reproductive medical services for women, previously unavailable in Qatar and the region.&rdquo; &ndash; H.H Sheikha Moza bint Nasser, Chairperson of Qatar Foundation
</div><div>Sidra Medicine represents the vision of Her Highness Sheikha Moza bint Nasser who serves as its Chairperson. This high-tech facility is home to world-class patient care, scientific expertise, and educational resources.</div></div></div><div></div>

Clinical Nurse – Case Management

Novant Health

<div>What We Offer:
<div>
Shift: Part-time Saturday and Sunday 7:00AM - 7:00PM</div><div>
(must be available for training on a Monday-Friday basis for 3-6 weeks)</div><div>
Location - Huntersville Medical Center, Huntersville, NC</div><div></div><div><br>
This role is ideal for an experienced medical social worker looking to join a collaborative team of case management professionals.</div><br>
<div></div><ul><li>
A dynamic part time opportunity in a growing community hospital</li><li>
Popular part-time weekender schedule offering special weekend incentive pay</li><li>
Access to continuing education and leadership support</li><li>
Inclusive culture grounded in teamwork, trust, and shared purpose</li></ul><div></div><div><br>
The MSW Case Manager serves as a leader of the complex discharge planning process and a valued member of the healthcare team. They collaborate with physicians and other members of the healthcare team to assess, plan, implement and evaluate proactive, complex and safe discharge plans. Collaborates with RN Case Manager&rsquo;s for guidance with medically complex cases. The MSW Case Manager is also responsible for facilitating coordination of care. The MSW Case Manager along with the other members of the healthcare team accepts responsibility, authority and accountability for management of care. This shall be in accordance with the current policies and procedures, mission, vision and values of Novant Health. Serves as a resource for discharge planning and care coordination for psychosocially complex cases. Maintains current knowledge of available community resources and post acute care options.</div>
What We're Looking For:
<ul><li><b>Education</b>: Graduate Degree, required.<ul><li>
Master's Degree in Social Work from school accredited by the Council on Social Work Education.</li></ul></li><li><b>
Experience</b>: Two or more years professional social work experience or two or more years healthcare experience, preferred. Case Management or related experience, preferred.</li><li><b>
Licensure/Certification: </b>Appropriate state approved curricula for restrictive interventions (facility specific) within 3 months of hire for Emergency Departments and Behavioral Health units, required.</li><li><b>
Additional Skills (required):</b> Weekend and holiday coverage.</li><li><b>
Additional Skills (preferred): </b>Knowledge/Competence of Microsoft office products and keyboarding.</li></ul>
What You'll Do:
<div>
Duties</div><br>
<div></div><ul><li>
Serves as a leader of the complex discharge planning process and a valued member of the healthcare team</li><li>
Collaborate with physicians and other members of the healthcare team to assess, plan, implement, and evaluate proactive, complex and safe discharge plans</li><li>
Collaborate with RN Case Managers for guidance with medically complex cases</li><li>
Serve as a resource for discharge planning and care coordination for psychosocially complex cases</li><li>
Responsible for facilitating coordination of care</li><li>
Maintain current knowledge of available community resources and post acute care options</li><li>
Accepts responsibility, authority and accountability for management of care in accordance with the current policies and procedures, mission, vision, and values of Novant Health</li></ul></div>

Case Manager MSW, Part-time

Kaiser Permanente

<div><div><b>Job Summary:</b></div><br>
<br>
<p>The Complex Case Manager is a Nationally Board Certified Professional. He/she is responsible for performing all activities on members referred to the complex case management program. This includes a comprehensive clinical evaluation, assessment and documented care plan in all domains including social determinants of health, psycho-social, financial, medications, ADL/IADLs and cognitive, coordinating and monitoring all services needed with a focus on providing education and the goal of self-management skills. Additional responsibilities include ensuring continuity of care through interaction and team- work with the Inpatient Case/Care Managers, Transition of Care staff, QRM staff, Population Care staff, Medical Office staff, Social Workers, Vendors and other KPGA staff. Educates Providers, member and caregivers and the promotion of quality care and a high level of member and/or caregiver satisfaction. The Complex Case Manager will ensure work demonstrates adherence to NCQA Standards of Excellence.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Reviews all referrals to the Complex Case Management Programs within designated timeframe per policy and procedure and evaluate for case management based on established guidelines to ensure compliance with NCQA standards. This includes the preliminary evaluation of benefits within KPGA and community resources available.</li><li>
Performs a thorough and objective assessment of the member including physical, psychosocial, environmental, financial, and health status expectation through the use of EMR and hospital records, contact with the member, significant others, caregivers and current medical caregivers (if permitted by the member).</li><li>
Obtains consent from the member/caregiver for participation in Complex Case Management.</li><li>
Develops a comprehensive plan of care based on the assessment and in conjunction with the treating practitioner, identifies specific interventions, objectives, and goals with anticipated targeted dates for member accomplishment and self-management.</li><li>
Communicates the plan of care to the member/caregiver and provides education to the regarding the members condition as necessary.</li><li>
Implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined in the plan of care.</li><li>
Establishes specific dates for follow-up and assesses the members status and progress toward the established goals and adjusts the plan of care as necessary.</li><li>
Performs referrals to other KPGA programs and coordinate referrals to community resources necessary to accomplish the goals and makes recommendations for modifications to the plan of care as necessary.</li><li>
Continuously evaluates and monitors all activities and/or services provided through the case management plan to determine the effectiveness of the plan.</li><li>
Documents all case management interactions and interventions according to guidelines including any pertinent patient information or arrangements in the members medical record.</li><li>
Identifies and Evaluates expected outcomes, utilization of services and associated costs of the plan of care as well as any proposed alternative plan of care and makes the necessary revisions.</li><li>
Coordinates and participates in case conferences on a regular basis with all Providers involved in the care and updates the plan of care as necessary.</li><li>
Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered in the most appropriate setting.</li><li>
Assists in the development and implementation of Continuous Quality Improvement (CQI) projects.</li><li>
Works closely with the member and practitioner to ensure that the most appropriate and cost- effective services are always provided to the member while maintaining quality outcomes.</li><li>
Performs hospital discharge follow up on assigned population. Arranges, coordinates, and facilitates appointments for the member as necessary.</li><li>
Maintains effective interaction/communication with members, nursing staff, inpatient care coordinators, the transitional review team, social workers, general reviewers, referral coordinators, and Kaiser Permanente medical offices to facilitate the case management process and to provide continuity of care.</li><li>
Identifies the need for discharge from the Case Management Program based on defined goals and criteria, and discharges the member after notifying the member and practitioner as well as any other resources such as the Social Worker, Transitional Review Team, etc.</li><li>
Performs as an integrated health care team member, providing continual education to HCT staff as to role and responsibilities in care coordination. Remains accessible to the HCT and attends all HCT meetings as appropriate.</li><li>
Collaborates effectively with Providers and other departments within the health plan by acting as a resource to TSPMG Providers, contracted consultants, Health Plan administrators and medical office staff and other departments within the organization.</li><li>
Provides case management updates to Providers and health care teams.</li><li>
Performs home visits as appropriate for members in case management.</li><li>
Knowledgeable and compliant with regional personnel, unit specific and departmental policies and procedures. Assists in the development of department protocols as needed.</li><li>
Participates in annual regional and departmental compliance training.</li><li>
Knowledgeable and compliant with Principles of Responsibility.</li><li>
Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform the job.</li><li>
Demonstrates understanding of HIPAA privacy regulations by maintaining confidentiality of Protected Health Information (PHI).</li><li>
Demonstrates doing the right thing and doing things the right way is an underlying premise in all work- related activities and is able to identify location of copy of Principles of Responsibility.</li><li>
Develops and maintains an awareness of how to report compliance issues and concerns. Identifies issues of wrong- doing and promptly investigates and reports to immediate supervisor or Director of Regional Compliance. Serves as a primary contact person between the medical offices and community agencies as it relates to coordinating and facilitating the appropriate level of care and provision of services.</li><li>
Collaborates with the social worker to provide information to members and HCTs regarding community resource referrals.</li><li>
Remains knowledgeable of contract benefits and current, industry utilization trends relevant state and Federal regulations, criteria, documentation requirements (including Medicare and HCFA) and laws that affect managed care and case/utilization management.</li><li>
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Team Leader and/or Manager.</li><li>
Under the guidance of the Team Leader and in consultation with other QRM and IQM staff, participates in the coordination, planning, development, implementation, and maintenance of all Complex Case Management Program department policies and procedures.</li><li>
Reviews the statistics of case management interventions with the Supervisor/Team Leader and adjusts based on findings.</li><li>
Performs quality of care and service reviews using identified quality indicators and refers cases identified as risk management, peer review or quality issues to Quality and Risk Management.</li></ul><div><br>
<b>Basic Qualifications:</b></div>
<div>Experience</div><br>
<br>
<ul><li>Minimum five (5) years of RN Clinical Nursing, social work, case management or utilization management (UM).</li><li>
Equivalent combination of case management/social work/UM training or RN experience may be considered.</li></ul><div>
Education</div><br>
<br>
<ul><li>High School Diploma or General Education Development (GED) required.</li></ul><div>
License, Certification, Registration</div>
<ul><li>Licensed Master Social Worker (Georgia) OR Licensed Clinical Social Worker (Georgia) OR Registered Professional Nurse License (Georgia) required at hire
</li></ul><ul><li>Case Manager Certificate within 12 months of hire from Commission for Case Managers Certification<br>
</li></ul><div>
<b>Additional Requirements:</b></div><br>
<ul><li>
Complex Case Management experience and/or certification.
</li><li>Excellent/highly skilled in the management of chronic conditions such as diabetes, cardiovascular conditions, behavioral-health, and chronic obstructive lung disease management COPD.</li><li>
Ability to work collaboratively with multiple healthcare professionals.</li><li>
Experience with managed health care delivery, benefits knowledge including Medicare and Medicaid.</li><li>
Functional knowledge of computers.</li><li>
Knowledge of ICD9/ ICD10 and/or CPT4 coding beneficial.</li><li>
Working knowledge of all relevant federal, state, local and regulatory requirements including Medicare/HCFA.</li></ul><div>
<b>Preferred Qualifications:</b></div><br>
<br>
<ul><li>Bachelors Degree in Nursing strongly preferred or four (4) years of experience in related field.</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:00 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Individual Contributor<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - Rgnl Mg Admn-Ccs Case Coord - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

Complex Case Manager

Baptist Health

<div><p>Shift: Day
</p><p>Working Hours:
</p><p>Summary:
<br>
The Case Coordinator II is accountable for the clinical and financial outcome of care for an assigned case load. He/she functions as an advanced practitioner in the role of clinician, educator, researcher, case manager, and advocate. Facilitates the care of observation and inpatients during their hospitalization by managing, coordinating and monitoring resources to achieve optimal level of independence and health for patients and families; clinical outcomes; utilization; service, and financial goals by performing the roles of assessor, planner, facilitator and advocate. The Case Coordinator II uses Continuous Improvement (CI) principles.
</p><p>Other information:
<br>
RN License, 5 years of appropriate clinical experience(adult Med/Surg); 3 years of supervisory experience preferred - charge nurse or team leader experience; Baccalaureate degree or experience commensurate with a degree. Master's Degree preferred; Knowledge and education, including but not limited to the following; clinical expertise, excellent observation skills, analytical thinking, problem solving, good verbal and written communication, knowledge of adult education principles, research process, change theory, management skills, financial analysis and group process. The Case Clinical Coordinator II is accountable for the clinical and financial outcome of care for an assigned case load; assists with staff development.
</p><p>This job will be authorized 80.00 hours bi-weekly.</p></div>

Clinical Case Coordinator II

Encompass Health

<div><p><b>Case Manager Career Opportunity</b></p><p><b><br>
Recognized for your abilities as a Case Manager</b><br>
Are you ready for a Case Management role that brings your career closer to home and heart? Join Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. As the leading provider of rehabilitation care in the nation, this opportunity 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. This is more than a career move; it's a chance to shape a future where care and compassion converge for truly meaningful outcomes.</p><p><b><br>
A Glimpse into Our World</b><br>
At Encompass Health, you'll experience the difference the moment you become a part of our team. Working with us means aligning with a rapidly growing national inpatient rehabilitation leader. We take pride in the growth opportunities we offer and how our team unites for the greater good of our patients. Our achievements include being named one of the &quot;World's Most Admired Companies&quot; and receiving the Fortune 100 Best Companies to Work For&reg; Award, among other accolades, which is nothing short of amazing.</p><p><b><br>
Starting Perks and Benefits</b><br>
At Encompass Health, we are committed to creating a supportive, inclusive, and caring environment where you can thrive. From day one, you will have access to:</p><ul><li>
Affordable medical, dental, and vision plans for both full-time and part-time employees and their families.</li><li>
Generous paid time off that accrues over time.</li><li>
Opportunities for tuition reimbursement and continuous education.</li><li>
Company-matching 401(k) and employee stock purchase plans.</li><li>
Flexible spending and health savings accounts.</li><li>
A vibrant community of individuals passionate about the work they do!</li></ul><p><b>
Become the Case Manager you always wanted to be</b></p><ul><li>
Work with interdisciplinary team, guiding treatment plans based on patient needs and preferences.</li><li>
Coordinate with interdisciplinary team to establish tentative discharge plan and contingency plans.</li><li>
Participate in planning for and the execution of patient discharge experience.</li><li>
Monitor patient experience: quality/timeliness/service appropriateness/payors/expectations.</li><li>
Facilitate team conferences weekly and coordinate all treatment plan modifications.</li><li>
Complete case management addendums and all required documentation.</li><li>
Maintain knowledge of regulations/standards, company policies/procedures, and department operations.</li><li>
Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions.</li><li>
Understand commercial contract levels, exclusions, payor requirements, and recertification needs.</li><li>
Attend Acute Care Transfer (ACT) meetings to identify trends and collaboratively reduce ACTs.</li><li>
Meet with patient/family per Patient Arrival and Initial Visit Standard within 24 hrs of admission.</li><li>
Perform assessment of goals and complete case management addendum within 48 hours of admission.</li><li>
Educate patient/family on rehabilitation and Case Manager role; establish communication plan.</li><li>
Schedule and facilitate family conferences as needed.</li><li>
Assist patient with timely procuring/planning of resources to avoid discharge delays or issues.</li><li>
Monitor compliance with regulations for orthotics and prosthetics ordering and payment.</li><li>
Make appropriate/timely referrals, including documentation to post discharge providers/physicians.</li><li>
Ensure accuracy of discharge and payor-related information in the patient record.</li><li>
Participate in utilization review process: data collection, trend review, and resolution actions.</li><li>
Participate in case management on-call schedule as needed.</li></ul><p><b>
Qualifications</b></p><ul><li>
License or Certification:<ul><li>
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).</li><li>
If licensure is required for one's discipline within the state, individual must hold an active license.</li><li>
Must meet eligibility requirements for CCM&reg; or ACM&trade; certification upon entry into this position OR within two years of entry into the position.</li><li>
CCM&reg; or ACM&trade; certification required OR must be obtained within two years of being placed in the Case Manager II position.</li></ul></li><li>
Minimum Qualifications:<ul><li>
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.</li><li>
For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred.</li><li>
2 years of rehabilitation experience preferred.</li></ul></li></ul><p>
</p><div><b>The Encompass Health Way
</b></div><div>We proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing!
</div><div>At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification.</div></div><p></p>

Case Manager

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