CAASE AMANGER - ST. ANTHONY'S REHAB

Hireez; Florida; On-site; USD 55,000 - 85,000; Full time

Job summary

Hireez is seeking a Case Manager in Florida to coordinate discharge planning for residents and/or patients, acting as a liaison among the care team, physicians and payors. The role supports access to community resources and programs and ensures timely assessments and documentation throughout the care continuum.

The candidate will work with interdisciplinary teams, manage insurance authorizations, and guide families through complex care transitions.

Qualifications

• Active RN or LPN license to practice in Florida
• CPR certification is required
• 1–3 years of experience in a health care facility
• Knowledge of computer office/clinical software
• Able to read, write and understand English

Responsibilities

• Interview residents/patients and complete assessments within 72 working hours and document in Medical Records
• Obtain timely insurance re-certifications and provide weekly updates for continued stay authorization
• Attend interdisciplinary team conferences to discuss status
• Conduct family conferences as needed
• Coordinate discharge planning and referrals to home health, long-term care, or outpatient services
• Educate on advanced directives and community resources
• Coordinate authorization from insurance for procedures, appointments and transportation
• Communicate patient status to responsible parties and interpret recommendations for care continuation
• Provide Medicare rights information and obtain signatures as required prior to discharge
• Disseminate Medicare Non-Coverage and Transfer/Discharge notices and obtain signatures
• Follow Medicare appeal processes and maintain logs
• Complete and post discharge forms and progress notes
• Serve as liaison with physicians and maintain ongoing communication
• Participate in daily management meetings to review status and feedback
• Perform follow-up calls within 72 hours of discharge
• Obtain levels of service increases when applicable
• Coordinate with third-party bundle payment programs when applicable
• Reasonable accommodations may be made to enable performance of duties
• Maintain required licenses, certifications and mandatory skill updates
• Comply with policies and regulations
• Perform other duties as assigned

Skills

Communication

English literacy

Education

RN/LPN license in FL

CPR certification

Tools

Healthcare software

Job description

General Information

Job Description: Case Manager

Classification: Non-Exempt

Job Code:

Salary Grade:

Date Approved:

Summary & Objective

The Case Manager coordinates discharge planning for residents and/or patients and helps manage their healthcare by acting as a liaison between the interdisciplinary team, the physicians and payor as related to their progress and status while in the facility. The Case Manager also assists residents and/or patients in getting access to community resources and programs.

Knowledge & Experience Requirements

• Clear and Active Registered Nurse or Licensed Practical Nurse license to practice in the state of Florida, Social Work or related clinical field
• CPR certification
• 1-3 years of experience in a Health Care Facility
• Must have knowledge of computer office/clinical software
• Must be able to read, write and understand the English language.

Essential Functions

• Interviews resident and/or patient and completes assessment within 72 working hours, and documents in Medical Record.
• Obtains timely insurance re-certifications and provides weekly updates verbal/written for continued stay authorization and enters into billing software. Utilizes the Trace program when communicating with insurance representatives.
• Attends interdisciplinary team conference to discuss resident and/or patient status.
• Conducts family conference meetings as needed.
• Discharge planning to the community with but not limited to referrals for home health care services, ordering durable medical equipment, arranging outpatient services referrals, referrals to Long Term Care settings, Assisted Living Facility and Skilled Nursing Facility as applicable.
• Educates with patient and/or family of advanced directives if applicable
• Educates patient/resident and/or family on community resources and programs.
• Coordinates and obtains authorization from insurance company for all procedures, appointments and transportation for all HMO residents and/or patients.
• Communicates with patient and/or responsible party when person served is approaching the end of rehabilitative care status and interprets recommendations for continuation of care.
• Provides Important Medicare Letter of Rights to resident and/or patient and/or family and obtains signature on form as warranted within the required timeframe prior to discharge if applicable.
• Provides Notice of Medicare Non-Coverage and Nursing Home Transfer and Discharge Notice to resident and/or responsible party and obtains signature within the required timeframe prior to discharge if applicable.
• Follows Medicare appeal process and keeps log as needed.
• Completes and posts discharge forms.
• Documents resident and/or patient progress notes as needed.
• Serves as a liaison with physician and continuously communicates regarding resident and/or patient's status and/or concerns.
• Participates in daily management team meetings to discuss patient and/or resident's status, census changes, and patient and/or resident's complaints or concerns.
• Conduct follow up phone calls within 72 hours of discharge and utilized worksheet questionnaire.
• Obtain HMO level increases such as IV's (high cost drugs), special equipment and change in skilled needs if applicable.
• Communicate and coordinate with third party bundle payment programs if applicable.

*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Other Duties

• Promotes customer service and hospitality and responds to and adequately resolves complaints or concerns from patient and/or resident's or families and informs to the Director, Case Management/Social Services.
• Provides orientation to new employees as needed.
• Maintain your required license, certifications and mandatory skill updates.
• Comply with all policies, local, state and federal laws and regulations.
• Perform other duties as assigned.

Supervisory Responsibility

• May serve as an interim department leader depending on need.

Physical Requirements

• Must be able to lift and/or move up to 50 pounds and push/pull up to 250+ pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.

Disclaimer

The job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.

EEOC Statement

CHS provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.