Case Manager

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Category Case Management

JOB TITLE:

Case Manager

REPORTS TO:

Administrator
FLSA STATUS:
Non-Exempt

JOB OVERVIEW:
In collaboration with the physician 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 plan 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. Coordinates
length of stay management within Medicare (CMS) guidelines and 60% compliance threshold.

• a. Meets with patient upon admission to discuss rehabilitation process and role of
  case manager.
• b. Conducts and documents initial patient assessment within 72 hours, to include
  psychosocial, family and disposition status; determines tentative initial discharge
  plans in conjunction with patient and family goals.
• c. Appropriately modifies approach to the patient based upon patient's age and
  developmental level.
• d. Involves the patient/family in the development of the plan of care by obtaining
  their goals for rehabilitation.
• e. Reviews goals with patient's family (with patient's permission) and third party
  payer.
• f. Maintains accurate up-to-date documentation in the medical records of patient and
  family contacts, communications with payers and other services performed on
  behalf of patient and family.
• g. Coordinates, evaluates, documents and reviews interdisciplinary team goals as
  they pertain to the plan of care and discharge plan.
• h. Coordinates team conferences.
• i. Documents in the medical record a summary of the team conference.
• j. Serves as the primary family contact (with patient permission) for the treatment
  team, communicating within 48 hours of the team conference. Also updates the
  external case manager and/or payer source regarding progress, plan and patient's
  future needs (as requested by payer source).
• k. Ensures the scheduling of family conferences, family participation in therapy and
  provides pertinent information to appropriate team members.
• l. Documents in the medical record a summary of the family conference.
• m. Coordinates completion of discharge plans by assisting with arrangements for
  family education, equipment and services as appropriate for patient discharge
  level of care.
• n. Calls patient or family as needed post-discharge to ensure planned discharge
  recommendations are occurring and to assess if additional services are needed.
• o. In collaboration with the Controller, monitors and ensures needs of per diem
  negotiations, recertification, concurrent reviews and timely reports.
• p. Participates in monitoring, analyzing and utilizing program evaluation data to
  promote quality of care and position hospital for success.
• q. Works closely with finance in order to facilitate Utilization Management
  program.
• r. Maintains good working relationships with other hospital departments,
  participates in hospital meetings and serves on hospital committee as requested.

• Language
  
  Skills:
  
  Able to communicate effectively in English, both verbally and in
  writing.
• Skills:
  
  Basic computer knowledge

• Current Louisiana Licensure as RN. Fifth year college or university program
  certificate; or two to four years related experience and/or training; or equivalent
  combination of education and experience. Knowledge of basic bookkeeping, office
  procedures, and electronic billing procedures. BCLS - required.

• I-Position is considered to have opportunity for routine exposure to blood borne pathogens in
  the normal performance of job duties.
• II
  - Position is considered to have occasional opportunity for exposure to blood borne
  pathogens in the normal performance of job duties.
• III-Position is considered to have no occupational exposure to blood borne pathogens in the
  normal performance of job duties

Position Requirements

Education and Experience:

Must have a high school diploma or equivalent.…