Case Mgr Inpatient Rehab

Wellstar Health System; Marietta (GA); On-site; USD 60,000 - 90,000; Full time

Job summary

Wellstar Health System in Marietta, GA is seeking a Social Worker/Case Manager to serve as the primary liaison among patients, families, and rehab teams. You will provide information on progress, referrals, and education, and coordinate discharge planning in line with NASW standards.

Responsibilities include case management, documentation, and collaboration with insurers to ensure appropriate coverage and timely approvals, while maintaining compliance with regulatory and organizational policies.

Qualifications

• Demonstrates skills or experience in case management.
• Strong computer skills required.
• Good communication skills (verbal and written).
• Excellent time management and organizational skills.
• Working knowledge of precertification processes.
• Working knowledge of medical terminology and basic computer proficiency.
• Counseling skills and knowledge of community resources.
• Understanding of adult and geriatric development and needs.

Responsibilities

• Manage case coordination for patient care and discharge planning.
• Document discharge issues and insurance-related progress in chart.
• Coordinate with interdisciplinary team and families for smooth discharge.
• Communicate with insurance providers for authorizations.
• Ensure compliance with regulatory standards and CARF requirements.

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Job Summary

Primary liaison between the patient, family, the rehab team, outside agencies and their representatives. The Social Worker/case manager provides information about patient's progress, referrals and educational information and adjustment counseling to patients and their families and coordinates the discharge planning process. Adheres to NASW professional standards, codes of ethics, system and department policies and procedures.

Core Responsibilities And Essential Functions

• CASE MANAGEMENT * Reviews all new admissions in EPIC and paper chart for completeness to assure compliance with insurance, pre-certification and DME requirements.
• * Documents discharge issues in the chart at appropriate intervals for progress findings.
• * Communicates with the team regarding progress and/or insurance issues.
• * Communication with insurance providers to obtain episodic authorization.
• * Coordinates team goals, the interdisciplinary team conference and the family education process to assure a smooth flow of care until discharge.
• * Executes various documents with the patient and family as needed.
• * Care coordination and follow-up with patient, family, team and physicians
• FINANCIAL RESPONSIBILITY * Monitors LOS efficiency and facilitates discharge plan process.
• * Enters necessary financial and precert information into CANOPY to ensure timely flow.
• * Works with physician and manager to resolve failed or denied patient approvals.
• * Communicates with insurance companies to assure appropriate coverage and claims management.
• * Works with families to assure appropriate resource identification, access and utilization
• COMMUNICATION * Communicates with AC and physicians to facilitate benefits and pre-cert information on insurance patients, internal and external referrals.
• * Serves as a resource for the interdisciplinary team, regarding insurance compliance issues.
• * Communicates to all stake holders regarding patient progress.
• * Meets with patients, families, team members and outside case managers to review patient progress, prepare for timely discharge and schedules the education process for patients and families.
• * Compliance * Assures authorization for equipment as required by insurance; facilitates discharge prescription assurance.
• * Assures documentation meets regulatory standards
• * Participates in chart audits as requested
• * Works with IRF-PAI Coordinator, physician and interdisciplinary team to assure regulatory and CARF compliance. Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education

• Associates Nursing or Bachelors Nursing or Masters Social Work

Required Minimum License(s) And Certification(s)

All certifications are required upon hire unless otherwise stated.

• CCM - Certified Case Manager or LCSW - Lic Clinical Social Worker GA or LMSW - Lic Master Social Worker GA or MSW - Master Social Worker or RN - Reg Nurse (Single State) or RN-COMPACT - RN - Multi-state Compact

Required Minimum Experience

Minimum 2 years experience in medical case management inpatient rehab Preferred

Required Minimum Skills

Demonstrates skills or experience in case management. Strong computer skills required. Good communication skills both verbal and written. Excellent time management/organizational skills; working knowledge of the precertification process; Working knowledge of medical terminology and basic computer proficiency required Demonstrated counseling skills, knowledge of community resources, federal and local guidelines, funding resources; understanding of adult and geriatric development and age appropriate care understanding of the effects of illness and disability and the impact on both patient and family.

Join us and discover the support to do more meaningful work- and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.