Care Manager/Case Manager - Rehab Hospital

PRN (as needed - looking for a candidate who has flexibility in their schedule)

Good Shepherd Rehabilitation Network has opened a state-of-the-art, 76-bed inpatient rehabilitation hospital that will revolutionize treatment and recovery options for people with complex medical conditions, such as stroke, spinal cord injury, brain injury and other serious injuries or illnesses.  The four-story, 123,000-square-foot facility on Center Valley Parkway features all private rooms and offers world-class physical rehabilitation care to patients who are recovering from complex and catastrophic conditions.

One of the most novel and exciting spaces to spur innovation in Good Shepherd’s new hospital is Empower . This first-of-its-kind space will give people with disabilities and other mobility challenges an environment where they can explore the latest advancements, like 3D printing, robotics, wearables, artificial intelligence and smart home and personal assistance devices, designed to promote healing and independence and make people’s lives better.

• Job summary
  • Develops an integrated link between patients, families, local resources, insurance representatives and hospitals, enhances communication among these parties to assure appropriate and timely utilization and access to services and exchange of information, therapeutic interventions and advocates for the rights and needs of patients.  
• Essential functions
  • Ascertains patient’s medical, psychological, emotional and social needs
    • By interviewing patients, completing initial care management assessment, screening for potential discharge planning needs, communicating with treatment team.
  • Develops therapeutic intervention plan according to needs
    • By exploring options, setting goals, establishing rapport with patient and significant others.
  • Obtains services and resources for patients
    • By ascertaining appropriateness and referring to community resources
    • Establishing rapport with agencies and support groups
    • Arranging appointments
  • Represents rights and needs of patients
    • By educating and informing patients about their rights
    • Advocating on their behalf with community resources, insurers, treatment team
  • Coordinates treatment and discharge plan
    • By leading interdisciplinary team meetings
    • Bridging communication between team members, ancillary departments, insurers and significant others.
  • Maintains documentation
    • By appropriate and timely notations in the medical record, departmental files, hand-off communication documents (i.e. POD report), electronic documentation systems and databases.
  • Addresses patient safety
    • By identifying and communicating patient safety issues to the team, patient/family
    • Relaying recommendations for a safe discharge plan to patient/family
    • Assisting to resolve care issues by making referrals to address identified needs
    • Reporting to regulatory agencies as required, facilitating appropriate utilization of services.
  • Coordinates utilization management processes
    • By reviewing clinical information based upon admission and continued stay criteria
    • Performing concurrent medical reviews to communicate to payers
    • Initiating physician advisor reviews for cases not meeting established criteria for admission and/or continued stay to facilitate appropriate utilization of services
    • Communicating denials from third party payers to the physician and coordinating a timely appeals process
    • Updating demographic information,
    • Obtaining signatures on admission paperwork and/or advance directives forms (where applicable)
  • Demonstrates a professional demeanor and maintains professional knowledge
    • By being flexible, responding positively to unexpected changes in the workload and work hours
    • Performing other duties as directed
    • Keeping abreast of regulations and policies related to utilization management and discharge planning, departmental staff meeting information.
• Qualifications
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    • Education
      • Bachelor's Degree required
      • Master's Degree preferred
    • Work Experience
      • 1-2 years of related experience required
    • Licenses / Certifications
      • Clinical license in appropriate discipline preferred