Case Manager II
Full-time!
Encompass Health Rehabilitation Hospital of Altamonte Springs
Tremendous professional abilities
Life-changing results
BE THE CONNECTION.
In your role as a Case Manager II you’ll have the opportunity to be the connection between your strong professional abilities and exceptional patient care that sets the standard. Apply your outstanding skills and knowledge in a different, more meaningful way. Make the most of your unique combination of talent, passion, and ambition with national post-acute care leader Encompass Health.
What Makes Encompass Health Careers Different—and Better:
Working at Encompass Health means being part of something special: A team that is passionate about making an impact on patients’ lives each day. Unlike the typical hospital setting, Encompass Health offers you the unique opportunity to walk alongside patients on their road to recovery from stroke, spinal cord injuries, neurological disorders, joint replacements, multiple trauma and cardiac/pulmonary conditions. As you help patients achieve goals and regain independence, you can form significant relationships with them and celebrate the successes they experience along the way.
Our culture of compassion and collaboration is founded on more than just the care we provide our patients; it is expressed in the values we live. We encourage and empower each employee to keep learning and growing by providing the resources to deliver a better way to care. At Encompass Health, you’ll find something decidedly different and more satisfying: A career that is challenging, inspiring and rewarding. Maximize your talent and join a team that is committed to setting the standard for better healthcare with this engaging opportunity:
Case Manager II
• Works with interdisciplinary team, guiding treatment plans based on patient needs and preferences.
― Facilitates the development of a safe and effective plan of care through early identification and thorough assessment of the patient’s needs and resources available.
― Promotes effective interdisciplinary team dynamics, communication and facilitates a positive working environment to achieve desired outcomes.
― Reviews therapy intensity report daily to identify patient non-compliance trends.
• Coordinates with interdisciplinary team to establish tentative discharge plan and contingency plans.
― Incorporates information from initial interview and consultation with team and patient/family.
― Establishes contingency discharge plans for high risk cases.
― Actively identifies barriers to discharge plan and communicates with patient/family and team to decrease or eliminate such barriers.
― Accurately updates and maintains discharge calendar.
• Participates in planning for, and ensures successful execution of, patient discharge experience.
― Confirms final discharge plans after consultation with team and patient.
― Prepares and reviews case management discharge paperwork and reviews with patient/representative at least 24 hours prior to discharge.
• Monitors patient experience: quality/timeliness/service appropriateness/payors/expectations.
― Promotes informed decision-making through explanation of choices, risks, and benefits to the patient/family member and interdisciplinary team.
• Facilitates team conferences weekly and coordinates all treatment plan modifications.
― Identifies potential complications relative to patient care and discharge plan after initial and ongoing team conferences.
• Completes case management addendums and all required documentation.
― Manages documentation such as, but not limited to, contact notes, Interdisciplinary Plan of Care (IPOC), team conference form, family conference, continues stay reviews and discharge instructions.
• Maintains knowledge of regulation/standards, company policies/procedures, and department operations.
― Maintains knowledge regarding state laws regarding competency and guardianship.
― Demonstrates understanding of the hospital’s patient outcomes and financial goals and the department’s impact on goal achievement.
― Incorporates knowledge of independence scoring process to evaluate accuracy of scores throughout length of stay.
― Uses RAND methodology to establish Length of Stay management to promote the effective utilization of hospital days or services, and will conduct timely reviews as needed. Notifies supervisor, business office, and patient of any coverage issues as they arise.
― Identifies the estimated LOS through RAND reports and will communicate this time frame to patient/family and interdisciplinary team.
• Reviews/analyzes case management reports including Key Care Indicators; plans appropriate actions. ― Keeps supervisor informed of reports, Key Care Indicators, and plan adjustments.
• Understands commercial contract levels, exclusions, payor requirements, and recertification needs.
― Obtains precertification/authorization from third party payors for noncontractual services, including but not limited to radiology, day hospital services, hematology testing, transportation, outside tests, orthotics/prosthetics.
― Demonstrates working knowledge of reimbursement parameters of payors, and effectively educates patients, family and staff on payor issues.
• Completes daily rounds to visit with each patient (family member when applicable).
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― Monitors current status, communicates new information, and evaluates patient/family satisfaction; completes documentation as needed.
• Attends Acute Care Transfer (ACT) meetings to identify trends and collaboratively reduce ACTs.
• Meets with patient/family per Patient Arrival and Initial Visit Standard within 24 hrs of admission.
• Performs assessment of goals and completes case management addendum within 48 hours of admission.
• Educates patient/family on rehabilitation and Case Manager role; establishes communication plan.
― Validates patient/family understanding of information.
― Provides education that enhances patient/family member knowledge and a motivation to participate in patient care.
• Schedules and facilitates family conferences as needed.
• Assists patient with timely procuring/planning of resources to avoid discharge delays or issues. ― Understands and assists with applications for Medicaid, SSI, Disability, etc.
• Monitors compliance with regulations for orthotics and prosthetics ordering and payment.
― Determines funding sources for post discharge needs.
― Facilitates referrals to Outpatient care teams or Home Health Services for continued or additional services as needed. ― Provides patients/family with Choice Letters regarding available options for post discharge care providers.
• Makes appropriate/timely referrals, including documentation to post discharge providers/physicians.
• Ensures accuracy of discharge and payor-related information in the patient record.
― Delivers Important Message from Medicare discharge notification within 2 days of discharge.
― Documents orthotics and prosthetics ordering and payment in PATCOM for Medicare primary patients/auto pay.
• Participates in utilization review process: data collection, trend review, and resolution actions.
• Participates in case management on-call schedule as needed.
• Reports questionable situations, concerns, complaints or harassment immediately.
• Organizes, plans, and manages time effectively to complete assignments.
• Completes mandatory training and courses required by completion date.
Credentials:
• 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.
Minimum Qualifications:
• 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.
Machines, Equipment Used:
General office equipment such as computer/laptop, telephone, copy/fax machine, calculator, scanner, etc.
• Microsoft Office software, to include Outlook, Word, and Excel.
Physical Requirements:
• Visual acuity, speech recognition, speech clarity.
• Ability to lift, lower, push, pull, and retrieve objects weighing a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling exceeds these minimum requirements.
Skills and Abilities:
• Oral communication, written communication, active listening. Must be able to speak and understand English.
• Information ordering, deductive reasoning, social perceptiveness, time management, critical thinking.
• Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
• Ability to work independently without continuous supervision.
Environmental Conditions:
• Indoor, temperature controlled, smoke-free environment.
• Handicapped accessible.
• May work under stressful circumstances at times.
Proficiency or Productivity Standards:
• Has regular, reliable, and predictable attendance and punctuality.
• Adheres to dress code including wearing ID badge.
• Adheres to Standards of Business Conduct.
• May be required to work weekdays and/or weekends, evenings and/or night shifts if needed to meet deadlines.
• May be required to work on religious and/or legal holidays on scheduled days/shifts.
• May be required to perform other duties as assigned by supervisor.
• This position will support cultural diversity by promoting and maintaining an inclusive work environment and culture that is respectful and accepting of diversity.
Enjoy competitive compensation and benefits that start on day one if eligible, including:
• Benefits that begin when you do.
• Affordable medical, dental and vision plans provided to meet the needs of full and part-time employees and their families.
• Generous paid time off that increases with tenure.
• Tuition reimbursement and continuing education opportunities.
• Company-matching 401(k) and employee stock-purchase plans.
• Flexible spending and health savings accounts.
About Us:
Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals and offer home health and hospice care in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what’s right, focus on the positive, and remain stronger together.
Realize the powerful difference you can make. Take this opportunity to join our team.
To learn more about us, please visit us online at encompasshealth.com
Connect with us:
Equal Opportunity Employer