Case Manager (CM)

Job Description

Facility Name: TGH Rehabilitation Hospital

Schedule: Full Time (some weekends may be required)

Your experience matters

TGH Rehabilitation Hospital is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Case Manager joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

More about our team

TGH Rehabilitation Hospital is a state-of-the-art, 80-bed inpatient acute rehabilitation hospital dedicated to helping individuals regain their independence and return to the lives they love following an injury or illness.

How you'll contribute

A Case Manager who excels in this role:

• Schedules family conferences and/or communicates with caregiver following each team conference and more often as needed to keep patient and designated caregiver informed of progress and provides appropriate information related to goal achievement, course of rehabilitation stay, and plans for discharge.
• Coordinates weekly patient care team conferences to facilitate development, monitoring and refinement of treatment plan to achieve identified patient goals and outcomes.
• Reviews the patient's assigned CMG and helps the team identify any potential missed comorbid conditions that are actively being treated during the patient's stay. Communicates any findings to the HIM team.
• Communicates effectively with nursing, therapy and other ancillary departments to ensure proper utilization.
• Assists with concurrent and retrospective utilization review activities including denials and appeals. Works with physicians to conduct peer review with payer medical director when indicated.
• Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech.
• Coordinates discharge planning needs including but not limited to; home health services, physician follow up care, durable medical equipment, medical supplies, healthcare services, outpatient therapy, dialysis, skilled nursing care, assisted living care, hospice care, private duty care, etc. Responsible for coordinating all patient care needs prior to discharge ensuring a safe thorough discharge plan. Ensures patient choice is offered and documented as per CMS' Conditions of Participation for Discharge Planning.
• Demonstrate use of effective case management skills to plan, coordinate and evaluate patient care and movement in the care continuum
• Supports the team in the development of individualized care plans
• Establishes and maintains a therapeutic relationship with patients and families
• Collect quality review data
• Participate in survey preparation activities
• Other duties as assigned

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage tailored benefit options for part-time and PRN employees, and more.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.

What we're looking for

• Current Registered Nurse or Social Work licensure or Healthcare professional licensure as Respiratory Therapist, Physical Therapist, Speech Language Pathologist or Occupational Therapist.
• Certification in Case Management or Rehabilitation Nursing preferred; for example, Commission for Case Manager Certification (CCM); Association of Rehabilitation Nurses (ARN) certification, American Case Management Association (ACM) or Board Certification in CM by the ANCC e.g.: RN-BC
• Minimum of 2 years social work or case management experience in an inpatient setting highly preferred; acute/rehabilitation hospital experience preferred.
• Effective oral and written communication skills in English, additional languages preferred.
• Basic computer skills in excel, word, outlook, power point, etc. required.
• Must have good organizational skills, time management skills and analytical ability in order to interpret information and carry out duties independently
• Must be cooperative and have the desire to be a team player.
• Must recognize and observe confidentiality principles.