Case Manager

ClearSky Rehabilitation Hospital Lakeshore; Rockwall (TX); On-site; USD 65,000 - 95,000; Full time

Job summary

ClearSky Rehabilitation Hospital Lakeshore in Rockwall, TX, is seeking a Case Manager to partner with physicians and a multidisciplinary team to develop a care plan for assigned patients and monitor progress toward outcomes.

The role involves discharge planning, documentation, coordination with payors, and adherence to accreditation standards. A clinical license or relevant experience is required, with acute care experience preferred.

Qualifications

• Bachelor's degree in relevant field or equivalent.
• Current state clinical licensure.
• At least 4 years of relevant experience.
• Acute care setting is preferred.

Responsibilities

• Communicates, collaborates, and coordinates with team members to provide quality patient care and to ensure positive patient outcomes.
• Facilitates communication during interdisciplinary team conference.
• Adheres to accreditation standards by TJC and CMS and state requirements.
• Documents communications and coordination of patient activities, medical necessity, and post-discharge equipment needs.
• Supports length of stay management and conducts utilization reviews.
• Communicates information for timely updates and authorizations with payors.
• May be required to work during inclement weather or staffing emergencies.
• Maintains safety and infection prevention standards for patients, visitors, and staff.
• Performs other duties as assigned to support organizational effectiveness.

Skills

Critical thinking

Interdisciplinary teamwork

Communication skills

Insurance knowledge

Documentation & records

Time management

Confidentiality

Professional relationships

Computer skills

Education

Bachelor's degree

Clinical licensure

4 years experience

Job description

Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve.

The Case Manager works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. Identifies and resolves barriers that hinder effective patient care. Actively involved in discharge planning process. This position must integrate company values into daily practice.

Essential Functions:

• Communicates, collaborates, and coordinates with team members to provide quality patient care and to ensure positive patient outcomes. Facilitates communication during interdisciplinary team conference.
• Responsible for accreditation standards and adheres to all standards set forth by the State and accrediting agencies of TJC and CMS.
• Documents communication and coordination or patient activities, medical necessity, and post discharge equipment and support needs in the health care record.
• Supports and facilitates length of stay management. Conducts utilization reviews.
• Communicates appropriate information for timely updates and authorizations with payors. Ensures the outcome of this information is timely communicated to clinical team and administration.
• May be required to work during inclement weather and other staffing emergencies.
• Provides an environment conducive to safety for patients, visitors, and staff. Assesses the risks for safety and implements appropriate precautions. Complies with appropriate and approved safety and Infection Prevention standards.
• Performs other duties as assigned to support overall effectiveness of the organization.

Minimum Job Requirements

Minimum Education & Experience

• Relevant Bachelor's degree; OR
• Current state clinical licensure; OR
• 4 years relevant experience required.
• Acute care setting preferred.

Required Licenses, Certifications, and/or Documentation:

• Clinical licensure required when required by state.
• Must maintain acceptable driving record, current driver's license, and insurability.

Required Knowledge, Skills, and Abilities:

• Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.
• Demonstrates critical thinking skills: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Knowledge of community resources to meet post-discharge clinical and social needs.
• Knowledge of clinical operations and procedures.
• Ability to establish and maintain pro-active relationships with internal interdisciplinary team members, insurance companies, physicians, referral sources, community service organizations and health care facilities.
• Ability to maintain quality, safety, and/or infection prevention standards.
• Demonstrates general computer skills including data entry, word processing, email, and record management.
• Effective organizational and time management skills.
• Effective written and verbal communication skills.
• Ability to maintain proper levels of confidentiality.
• Ability to work closely and professionally with others at all levels of the organization.

Physical Requirements Over the Course of a Shift:

• A significant amount of standing and walking.
• Lifting/exerting of up to 25 lbs.
• Possible exposure to bodily fluids.
• Visual acuity required for patient assessment and documentation.
• Acute hearing required for accurate patient assessment.
• Sufficient manual dexterity to operate equipment and computer keyboard.
• Close vision and the ability to adjust focus.