What are the responsibilities and job description for the CASE MANAGER-MSW | REHAB SERVICES position at MEDICAL WEST HOSPITAL AUTHORITY?
About the Role:
The Case Manager for the Inpatient Rehabilitation Unit is responsible for the coordination and delivery of services to patients and families/caregivers within the limits of the financial resources of the patient. The Case Manager will act as a liaison to the payor source assuring cost effectiveness of treatment provided by the rehabilitation team; facilitates and coordinates the discharge planning process; serves as a patient and family advocate to coordinate and direct effective communications regarding the patient’s care; subject to call back as required.
Qualifications:
Must either have a licensure from the Alabama State Board of Social Workers as a licensed Social Worker or the Alabama State Board of Nursing as a Registered Nurse. One to two years in case management/social work experience in the acute care, rehabilitation, or workers compensation setting is required.
A minimum of BLS is required. BLS must be obtained within 30 days of hire. BLS must be renewed per BLS guidelines and up to date.
Responsibilities:
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
1) Provides case management services to all assigned patients and their families to ensure appropriate treatment, benefit utilization, and discharge planning. |
2) Tracks length of stay to ensure that discharges are timely, given coverage, patient progress, and discharge destination. Initiates appeals process per policies and procedures to extend length of stay when appropriate.
|
3) Plays an active and ongoing role in the investigation process, in order to maximize insurance resources availability.
|
4) Functions as a liaison to the referral source and the payor to insure effective communication regarding the preliminary plan of care, progress towards program goals, and expected discharge plans.
|
5) Coordinates IRF Team Conference/Staffing Meetings weekly and assures timely reporting (verbal and written) to all external review parties.
|
6) Performs other related responsibilities as required or directed.
|
7) Schedules clients outside appointments as necessary and coordinates medical care as directed by physician. Completes appropriate paperwork prior to outside services being scheduled.
|
8) Ensures that no less than weekly contact is maintained with the family to facilitate family involvement, appraise the family of patient progress, coordinate discharge planning, and investigate funding issues.
|
9) Ensures the quality, timeliness and confidentiality of medical records documentation in accordance with the facilities' defined policies and procedures.
|
10) Actively participates in departmental meetings, in-service education and professional affiliations to enhance professional growth and remain up to date with trends in case management practices.
|
11) Communicates with the Business Services Department on pre-certification, continued stay reviews, and additional sources of insurance coverage as needed.
|
12) Negotiates, orders, and arranges delivery of services, equipment, and supplies during a client's stay and discharge alone or in conjunction with therapy services.
|
13) Facilitates and coordinates the discharge planning process; serves as a patient and family advocate to coordinate and direct effective communications regarding the patient’s care.
|
14) Acts as a liaison to the payor source assuring cost effectiveness of treatment provided by the rehabilitation team.
|
15) Contributes to a positive work climate and the overall team effort of the department. |