About This Role
Being a Case Manager at Encompass Health means acting as a vital link between patient care and its transformative impact, leveraging clinical expertise to manage resources and coordinate care from admission to post-discharge. This role suits a professional who wants to contribute to the well-being of individuals in their community and shape a future where care and compassion converge for meaningful outcomes.
Responsibilities
- Work with the interdisciplinary team, guiding treatment plans based on patient needs and preferences
- Coordinate with the interdisciplinary team to establish a tentative discharge plan and contingency plans
- Participate in planning for and the execution of the patient discharge experience
- Monitor patient experience: quality, timeliness, service appropriateness, payors, and 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 and 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 the patient and family per Patient Arrival and Initial Visit Standard within 24 hours of admission
- Perform assessment of goals and complete case management addendum within 48 hours of admission
- Educate patient and family on rehabilitation and the Case Manager role; establish a communication plan
- Schedule and facilitate family conferences as needed
- Assist patient with timely procuring and planning of resources to avoid discharge delays or issues
- Monitor compliance with regulations for orthotics and prosthetics ordering and payment
- Make appropriate and timely referrals, including documentation to post-discharge providers and physicians
- Ensure accuracy of discharge and payor-related information in the patient record
- Participate in the utilization review process: data collection, trend review, and resolution actions
- Participate in the case management on-call schedule as needed
Requirements
- 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
