Case Manager

Job Description

Job Description

Description:

Exalt Health, an acute rehabilitation hospital, provides an intensive rehabilitation program, and admitted patients must be able to tolerate three hours of intense rehabilitation services per day. Focused on caring for patients with complex rehabilitative needs such as stroke, spinal cord injury, brain injury, head trauma, medically debilitation conditions, neurological disorders, cardio-pulmonary amputations, orthopedic injuries, and multiple major traumas.

Position Summary

In collaboration with the physician, the Case Manager provides individual program management for each patient to ensure the patient’s progression through the continuum of care in a manner that achieves the desired clinical and financial outcomes. Monitors and manages clinical and financial coordination of treatment plans of assigned patients to ensure timely, cost-effective, individualized service delivery. Works with rehabilitation patients with various disabilities including, but not limited to: spinal cord injury, brain injury, cerebrovascular accident, amputation, neurologic disorders, orthopedic conditions, and arthritis.

Essential Duties and Responsibilities

• Comprehensive Assessment: Conduct thorough psychosocial assessments for patients and their families, identifying needs, barriers to care, and support systems.
• Collaborative Care Planning: Participate in interdisciplinary team meetings to develop individualized care plans that address medical, functional, and psychosocial needs.
• Resource Navigation: Identify and connect patients and families to appropriate community resources, financial assistance programs, and post-discharge support services.
• Discharge Planning: Proactively initiate and coordinate comprehensive discharge plans, ensuring safe and timely transitions to the next level of care (home, skilled nursing facility, etc.).
• Insurance and Authorization Management: Work closely with insurance providers to obtain authorizations for treatment, provide updates on patient progress, and address any coverage-related issues.
• Advocacy and Support: Serve as a patient and family advocate, providing emotional support and guidance throughout the rehabilitation process.
• Documentation and Reporting: Maintain accurate and timely documentation in patient records, including assessments, care plans, progress notes, and discharge summaries.

Knowledge, Skills, and Abilities

License or Certification:

• Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, Social Worker, 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
• CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager position.

Minimum Qualifications:

• For Nursing, must possess a minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in states where the 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 a graduate degree is preferred.
• 2 years of rehabilitation experience preferred.

Skills and Abilities, Proficiency and Productivity Standards

• Respect patient rights and promote customer satisfaction.
• Organizes and prioritizes tasks and projects, accurately completing job responsibilities within the specified time constraints.
• Excellent attention to detail and accuracy.
• Analytical and problem-solving abilities.
• Ability to work under deadlines and handle multiple tasks.
• Speaks and communicates English effectively in verbal and written format; writes legibly.
• Reading and comprehension at the level necessary to perform job duties appropriately.
• Works cooperatively with co-workers and other hospital employees
• Functions proficiently in a Microsoft Windows environment (Outlook, Word, Excel, PowerPoint)

Exalt Health is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.