Case Manager
Company: Ascension Saint Thomas Rehabilitation Hospital
Location: Nashville
Posted on: May 27, 2023
Job Description:
Description
Ascension Saint Thomas -Rehabilitation HospitalCase Manager
Part-timeAscension Saint Thomas Rehabilitation Hospital is a
state-of-the-art, 40-bed inpatient acute rehabilitation hospital
dedicated to the treatment and recovery of individuals who have
experienced a loss of function due to an injury or illness. JOB
SUMMARY:Coordinates management of care and ensures optimum
utilization of resources, service delivery and compliance with
external review agencies. Provides ongoing support and expertise
through comprehensive assessment, care planning, plan
implementation and overall evaluation of individual patient needs.
Enhances the quality of patient management and satisfaction, to
promote continuity of care and cost effectiveness through the
integration of functions of case management, utilization review and
management and discharge planning. - -Provides ongoing support and
expertise through comprehensive assessment, care coordination, plan
implementation and overall evaluation of individual patient needs
while ensuring patient preferences. - -The Case Manager (CM) is
responsible for providing care coordination including needs
assessment and identification of care options, communication with
patients and families in an interdisciplinary environment
consistent with the position's qualifications, professional
practices and ethical standards.ESSENTIAL FUNCTIONS:
Completes departmental orientation,
initial and annual competencies.Assists with departmental specific
performance improvement initiatives collecting and reporting data
as requested by supervisor.As appropriate, consults other
departmental staff to collaborate in patient care delivery,
identify barriers to care and or discharge and develop
solutions/resolution.Completes documentation per workflow timeline
and content requirements -including completion of the Individual
Plan of Care (IPoC) per CMS guidelines.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.Identifies trends that impact
the quality, cost effectiveness, patient experience and delivery of
care services and brings to departmental leadership meetings for
discussion and action.Performs intake assessment on patient within
24 to 72 hours of admission, preferably within 48 hours.Performs
follow-up assessments per Case Management Plan and/or hospital
policy.Demonstrates an ability to be flexible, organized and
function under stressful situations.Other duties as assigned. - - -
- - - - - - - - - - - - - - - - - - - - - - - - -Qualifications
Qualifications
Certification in Case Management or
-Registered nurse or -licensed social worker.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
independentlyMust be cooperative and have the desire to be a team
player.Must recognize and observe confidentiality principles.
Keywords: Ascension Saint Thomas Rehabilitation Hospital, Nashville , Case Manager, Executive , Nashville, Tennessee
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