• Case Manager (RN or MSW)

    Select Medical (Columbus, OH)


    Overview

    OhioHealth Rehabilitation Hospital

    *A joint venture with Select Medical & OhioHealth*

     

    Columbus, OH

     

    RN Case Manager

     

    (RN or MSW)

     

    $5,000 Sign-On Bonus

    Benefits of becoming a Case Manager with us:

    + Manageable case loads

    + Impact on patient's recovery process and quality of life

    + High success rate of patients being discharged home

    + Competitive rates

    + Team-oriented culture

    + A network of over 50K employees nationwide with advancement and relocation opportunities

    + Comprehensive benefits package for Full-time employees (including medical, dental, vision, 401k, life insurance, short and long term disability, and tuition assistance)

    Responsibilities

    Position Summary

    The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. The Case Manager assesses the psychosocial needs of the patient and provides intervention as part of the discharge planning process. The primary job functions in Case Management include: Clinical Interventions/Discharge and Care Planning Management; Fiscal Management; and Payer/Referral Management.

    Job-Specific Duties/Competencies

    **Clinical Interventions/Discharge and Care Planning Management:** Responsible for functioning as the liaison among all parties involved with the patient both within the hospital and in the community as it relates to the development and implementation of a safe and appropriate discharge plan, as well as the supervision of clinical interventions that may become critical to the development and implementation of the discharge plan. Provides psychosocial assessment and intervention as part of the discharge care planning process. The Case Manager participates as part of the interdisciplinary team developing, implementing, reviewing and revising the interdisciplinary plan of care.

    **Fiscal Management:** Assures responsiveness to payer systems by maintaining ongoing communication and serving as the primary contact for all external payer sources, in turn generating revenue, enhancing reimbursement, minimizing financial risk and assuring payment for the hospital. Maintains a thorough understanding of insurance coverage and benefits, providing interpretation to patients/families of their insurance and providing patient advocacy as needed.

    **Payer/Referral Management:** Identifies and fulfills the requirements and needs of payer and referral sources, overseeing negotiations of continued stay rationale, length of stays, and appeals process. Initiates activities to develop positive business relationships with payers and referral sources in order to promote repeat business and represent the hospital as a quality institution.

     

    Responsible for attending education/in-servicing on current trends in case management, policies and procedures of the Institute, and changes in governmental, regulatory, and accrediting agencies to ensure compliance with standards of practice.

     

    Assures personal compliance with departmental documentation and timeliness of the same, i.e.: initial assessments, advanced directives, team conference reports. Conducts chart audits on a regular basis to maintain compliance, as requested by manager.

     

    Develops and maintains updated departmental community resources materials and patient education materials. Responsible for keeping abreast of current information regarding entitlement programs patients may need to utilize.

     

    Identification of inter-department and intra-department performance improvement projects, and carrying out of same.

     

    Coordinates with other departments, i.e.: Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management outcomes for the patient.

     

    Is responsible for developing and maintaining effective interdisciplinary working relationships with other clinical treatment team members, i.e.: medical, psychology, nursing, therapy, therapeutic recreation, vocational and dietary, in order to assure clinical outcomes that are appropriate, cost-effective, and beneficial to the patient.

     

    Performs all other duties as requested.

    Qualifications

    Minimum Qualifications

    + Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.

    Previous Experience

    + Previous experience in Case Management and Discharge Planning preferred.

    + CCM Certification Preferred.

     

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    **Job ID** _326837_

    **Experience (Years)** _1_

    **Category** _Case Management - Case Manager_

    **Street Address** _1087 Dennison Avenue, 4th Floor_