Case Manager II

ScionHealth; Louisville (KY); On-site; USD 65,000 - 90,000; Full time

Job summary

Kindred Hospital Louisville at Jewish Hospital is a 30-bed long-term acute care facility within Jewish Hospital, offering 24/7 clinical care to support extended recovery. The role focuses on coordinating patient care, ensuring optimal resource use, and integrating case management with utilization review and discharge planning to promote continuity of care.

The position requires RN or Social Work licensure, 2+ years in healthcare, and strong communication skills to engage with clinicians,

Qualifications

• RN or Social Work licensure with appropriate state credentials
• 2+ years in healthcare setting required
• Experience in case management, utilization review or discharge planning preferred

Responsibilities

• Coordinate clinical and psychosocial activities with the interdisciplinary team and physicians
• Monitor patient stays for effective care coordination and cost containment
• Refer high-risk patients for additional support as appropriate
• Serve as patient advocate to support informed decisions by patients and families
• Participate in care rounds/conferences to review goals and resource utilization
• Collaborate with post-acute providers and payors in planning care throughout the continuum

Skills

Interdisciplinary coordination

Critical thinking

Microsoft Office

Communication

Time management

English fluency

Education

Postsecondary nursing or related

BSN/MSN/BSW/MSW preferred

Tools

Electronic Health Records

Job description

Description

Kindred Hospital Louisville at Jewish Hospital is a 30-bed long-term acute carehospital, with all private rooms, set within Jewish Hospital. We offer the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care 7 days a week so you can start your journey to wellness anytime. For added convenience, we are located in the heart of the Jewish Hospital campus in downtown Louisville, and easily accessible from main roads and highways.

Job Summary

Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum 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.

Essential Functions

Care Coordination

• Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.


• Monitors all areas of patients’ stay for effective care coordination and efficient care facilitation.


• Remains current from a knowledge base perspective regarding reimbursement modalities, communityresources, case management, psychosocial and legal issues that affect patients and providers of care.


• Appropriately refers high risk patients who would benefit from additional support.


• Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient’s andfamily’s ability to make informed decisions.


• Demonstrates knowledge of the principles of growth and development over the life span and the skillsnecessary to provide age appropriate care to the patient population served.


• Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimizeresource utilization, provide family education and identified post hospital needs. Collaborates with clinicalstaff in the development and execution of the plan of care, and achievement of goals.


• Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors,and others in the planning of the patients’ care throughout the care continuum.

Knowledge/Skills/Abilities/Expectations

• Knowledge of government and non-government payor practices, regulations, standards andreimbursement.


• Knowledge of Medicare benefits and insurance processes and contracts.


• Knowledge of accreditation standards and compliance requirements.


• Ability to demonstrate critical thinking, appropriate prioritization and time management skills.


• Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheetsoftware.


• Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtaincooperation/collaboration from hospital leadership, as well as physicians, payors and other externalcustomers


• Demonstrates good interpersonal skills when working or interacting with patients, their families and otherstaff members.


• Approximate percent of time required to travel, 0%


• Must read, write and speak fluent English.


• Must have good and regular attendance.


• Performs other related duties as assigned.

Qualifications

Education

• Postsecondary (Cert/Diploma/Program Grad) from an accredited school of nursing (Required) And


• Bachelor’s Degree in nursing or social work: BSN, MSN, BSW or MSW (Preferred)

Licenses/Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure in the state of practice Upon Hire (Required) Or


• LCSW- License Clinical Social Worker LCSW or LSW Upon Hire (Required) Or


• CSWCM - Social Work Case Manager Certification Upon Hire (Preferred)

Experience

• 2+ years experience in healthcare setting (Required) And


• Prior Experience in case management, utilization review, or discharge planning (Preferred)