DIRECTOR, CASE MANAGEMENT - Full Time
Company: St. Johns Rehab & NSG CTR
Location: Fort Lauderdale
Posted on: September 11, 2020
Summary & ObjectiveThe Director, Case Management oversees staff
of case managers and develops and implements case management
programs, including utilization review, discharge planning, and
managed care contracting or negotiation. Evaluates patient care
data to ensure that care is provided in accordance with clinical
guidelines and organizational standards.Essential Functions
- Interviews resident and/or patient and completes assessment
within 48 working hours, and documents in Medical Record.
- Obtains timely insurance re-certifications and provides weekly
updates verbal/written for continued stay authorization and enters
into billing software.
- Attends interdisciplinary team conference to discuss resident
and/or patient status.
- Conducts family conference meetings as needed.
- Discharge planning to the community with but not limited to
home health, durable medical equipment, outpatient services
referrals, Long Term Care, Assisted Living Facility and Skilled
- Educates patient and/or family of advanced directives.
- Educates community resources and programs to patient and/or
- Coordinates and obtains authorization from insurance company
for all procedures, appointments and transportation for all HMO
residents and/or patients.
- Communicates responsible party when person served is
approaching the end of rehabilitative care status and interprets
recommendations for continuation of care.
- Provides Important Medicare Letter of Rights to resident and/or
patient and/or family and obtains signature on form as warranted
within 24 hours prior to discharge.
- Follows Medicare appeal process as needed.
- Completes and posts discharge notification forms prior to
discharge to interdisciplinary team.
- Documents resident and/or patient progress notes on a weekly
basis or as needed in the Medical Record.
- Manages resident and/or patient's length of stay according to
their medical needs.
- Serves as a liaison with physician and continuously
communicates regarding resident and/or patient's status and/or
- Participates in daily, weekly or monthly management team
meetings to discuss patient and/or resident's status, census
changes, personnel, or patient and/or resident's complaints or
concerns to ensure an effective Quality Assurance Performance
Improvement (QAPI) program.*Reasonable accommodations may be made
to enable individuals with disabilities to perform the essential
functions of the position.Other Duties
- Acts as a designee in the absence of the Grievance Coordinator
- Contacts appropriate state agency when unsafe discharge,
neglect and/or abuse is suspected in collaboration with Risk
Manager and interdisciplinary team if applicable.
- Ensures Case Management Department is prepared for
- Promotes customer service and hospitality and responds to and
adequately resolves complaints or concernsfrom patient and/or
resident's or families.
- Completes employee evaluations on a timely basis. Accurately
and objectively assesses performance.
- Promotes positive employee engagement, teamwork, and mutual
respect and safety work practices.
- Maintain mandatory skill updates
- Comply with all policies, local, state and federal laws and
- Perform other duties as assignedSupervisory Responsibility
- May serve as an interim department leader depending on
- Must be able to lift and/or move up to 50 pounds and push/pull
up to 250+ pounds, walk, climb stair or ladders, stand on feet for
extended periods of time, etc.DisclaimerThe job description is not
designed to cover or contain a comprehensive listing of activities
duties or responsibilities that are required of the employee. Other
duties, responsibilities and activities may change or be assigned
at any time.EEOC StatementCHS provides equal employment
opportunities to all employees and applicants for employment and
prohibits discrimination and harassment of any type without regard
to race, color, religion, age, sex, national origin, disability
status, genetics, protected veteran status, sexual orientation,
gender identity or expression, or any other characteristic
protected by federal, state or local laws.This policy applies to
all terms and conditions of employment, including recruiting,
hiring, placement, promotion, termination, layoff, recall,
transfer, leaves of absence, compensation and training.PM19
Knowledge & Experience Requirements
- Clear and Active Registered Nurse or Licensed Practical Nurse
license to practice in the state of Florida, Social Work or related
- CPR certification
- 5+ years of experience in a Health Care Facility
- Must have knowledge of computer office/clinical software
- Must be able to read, write and understand the English
Keywords: St. Johns Rehab & NSG CTR, Fort Lauderdale , DIRECTOR, CASE MANAGEMENT - Full Time, Executive , Fort Lauderdale, Florida
Didn't find what you're looking for? Search again!