Case Manager Inpt Rehab Unit
Wellstar Health System, Roswell, GA, United States
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.
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, 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.
Communicates 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.
Enter necessary financial and pre‑certification 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‑certification information on insurance patients, internal and external referrals.
Serves as a resource for the interdisciplinary team regarding insurance compliance issues.
Communicates to all stakeholders regarding patient progress.
Meets with patients, families, team members and outside case managers to review patient progress, prepare for timely discharge and schedule 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
Associate’s Nursing or Bachelor's Nursing or Master’s 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 pre‑certification 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.
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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, 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.
Communicates 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.
Enter necessary financial and pre‑certification 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‑certification information on insurance patients, internal and external referrals.
Serves as a resource for the interdisciplinary team regarding insurance compliance issues.
Communicates to all stakeholders regarding patient progress.
Meets with patients, families, team members and outside case managers to review patient progress, prepare for timely discharge and schedule 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
Associate’s Nursing or Bachelor's Nursing or Master’s 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 pre‑certification 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.
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