Case Manager II
- Gadsden, AL
- Permanent
- Full-time
- Affordable medical, dental, and vision plans for both full-time and part-time employees and their families.
- Generous paid time off that accrues over time.
- Opportunities for tuition reimbursement and continuous education.
- Company-matching 401(k) and employee stock purchase plans.
- Flexible spending and health savings accounts.
- A vibrant community of individuals passionate about the work they do!
- Work with interdisciplinary team, guiding treatment plans based on patient needs and preferences.
- Coordinate with interdisciplinary team to establish tentative discharge plan and contingency plans.
- Participate in planning for and the execution of patient discharge experience.
- Monitor patient experience: quality/timeliness/service appropriateness/payors/expectations.
- Facilitate team conferences weekly and coordinate all treatment plan modifications.
- Complete case management addendums and all required documentation.
- Maintain knowledge of regulations/standards, company policies/procedures, and department operations.
- Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions.
- Understand commercial contract levels, exclusions, payor requirements, and recertification needs.
- Attend Acute Care Transfer (ACT) meetings to identify trends and collaboratively reduce ACTs.
- Meet with patient/family per Patient Arrival and Initial Visit Standard within 24 hrs. of admission.
- Perform assessment of goals and complete case management addendum within 48 hours of admission.
- Educate patient/family on rehabilitation and Case Manager role; establish communication plan.
- Schedule and facilitate family conferences as needed.
- Assist patient with timely procuring/planning of resources to avoid discharge delays or issues.
- Monitor compliance with regulations for orthotics and prosthetics ordering and payment.
- Make appropriate/timely referrals, including documentation to post discharge providers/physician
- Ensure accuracy of discharge and payor-related information in the patient record
- Participate in utilization review process: data collection, trend review, and resolution actions.
- Participate in case management on-call schedule as needed.
- License or Certification:
- 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).
- 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 OR within two years of entry into the position.
- CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager II position.
- 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.
- For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor’s degree and graduate degree is preferred.
- 2 years of rehabilitation experience preferred.