Hospital Corporation of America

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Case Manager/Social Worker - PRN - Weekdays and Weekends

at Hospital Corporation of America

Posted: 2/19/2019
Job Status: On Call
Job Reference #: 06676-61192
Keywords: patient, health

Job Description

St. David'sRehabilitation Hospital, located at St.David's Medical Center, is part of St.David's HealthCare—one of the largest health systems in Texas, which wasrecognized with a Malcolm BaldrigeNational Quality Award in 2014. St. David's Rehabilitation Hospitalfeatures private rooms, state-of-theart technology and the largest rehab poolin the market to support the most comprehensive aquatic therapy program in theregion. It also features three satellite facilities located at St.David's North Austin Medical CenterSt.David's Round Rock Medical Center and St.David's Georgetown Hospital. All St. David's Rehabilitation facilitiesprovide comprehensive rehabilitative care for patients with neurologicalconditions, including stroke, and orthopedic illnesses or injuries.

 

POSITIONSUMMARY

Performs and providesprofessional case management services in the Rehabilitation Center in order to(1) provide for the overall coordination in the delivery of services andtreatment planning, (2) ensure and document effective cost management tomaximize financial resources and utilize available resources, (3) promote thedevelopment of positive relationships between the facility staff, the patientand family, funding representatives and other involved or interested parties,(4) ensure continuity of care is maintained post-discharge, (5) assist infacility compliance with all relevant standards of care and treatment, and (6)assist in the development and implementation of new products and services,staff education and training, and good management practices.

Essential Duties/Responsibilities

Provides Financial Planning and Coordination

  • Works cooperativelywith the Admissions Office and Business Services to facilitate and ensureproper pre-certification of patients for hospitalization and rehabilitationtreatment from third party payors. Serves as the liaison between the Admissions and Business areas and CaseManagement.
  • Communicates crucialinformation on policy coverage, limits, required documentation and otherrelevant financial characteristics of coverage to designated facility staff andmedical providers
  • In conjunction withother key staff, analyzes admission information on all patients to determine iftreatment needs of the patient can be met within the constraints of fundinglimitations and parameters.
  • Ensures requireddocumentation and justification is provided to third party payors to obtainre-certification for continued hospitalization and treatment as needed.
  • Serves as liaisonbetween the treatment team and the funding sources, maintaining regular contactas required to inform of the patient's status, progress, required treatmentsand estimated necessary length of stay.
  • Negotiates rateswith payors when required, with administrative approval.
  • Works with thepatient and family to identify financial resources available to them in theprovision of rehabilitation services, both inpatient and post-discharge.
  • Provides a routinereport on effective utilization of case management services related to costcontainment, revenues generated and interventions resulting in a more positiveoutcome with the patient, family, funding source or other involved party.

Coordinates Treatment Planning.

  • Participates andassists in the assessment of the patient's rehabilitation needs, payingparticular attention to strengths and weaknesses which might advance or impedethe treatment of the patient.
  • Participates andassists in the assessment of the patient's rehabilitation needs, payingparticular attention to strengths and weaknesses which might advance or impedethe treatment of the patient.
  • Attends and participatesin team conferences and team meetings.
  • Schedules andcoordinates family conferences as needed.
  • Works cooperativelywith the attending physician, program supervisor, and other team members in thedevelopment, implementation, review, and documentation of the MasterInterdisciplinary Treatment Plan (MITP) and in the coordination of the deliveryof services to the patient and family.
  • Communicatesroutinely with the patient, family, physician, team members, business services,funding sources, and other interested parties on the status of the patient'streatment plan, progress toward achieving treatment goals, identification ofcurrent issues or problems, problem-solving, and to assist with conflictresolution when necessary.
  • Reviews the initialand updated treatment plans with the patient and family, obtains requiredsignatures, and provides their feedback on expectations, concerns, and desiredoutcomes to the treatment team.
  • Assists inmonitoring utilization review standards for treatment and patient care, andproviding required documentation for the department as required.

Coordinates Discharge Planningand Continuity of Care.

  • Collaborates withthe patient and family to determine probably discharge plans and needs, and toidentify available resources and support systems.
  • Works cooperativelywith other team members, patient, family, and physicians to identify patientneeds and anticipated functional level at discharge to develop a realistic andcomprehensive discharge plan and a discharge date.
  • Makes necessaryreferrals and coordinates the smooth transition of the patient from thefacility to the appropriate discharge setting.
  • Completes thedischarge instructions and provides to the patient or responsible party.  Completes a discharge summary and files inthe chart for each assigned patient.
  • Monitors andcoordinates the number and timeliness of all discharges to facilitateadmissions and minimize disruption to the unit.

Performs General Duties

  • Assists with programdevelopment for case management and related areas.
  • Assists in thedevelopment, implementation, and monitoring of polices and protocols related tocase management
  • Serves on taskforces and committees as required.
  • Meets allrequirements for quality and timeliness of documentation.
  • Attends continuingeducation per requirements for profession and position.
  • Performs otherduties and responsibilities as assigned, which may include photocopying,typing, filing, transport of patients, mathematical calculations, driving amotor vehicle, lifting objects, use of fire and safety equipment, chargeentries, word processing, use of computer and other office skills peripheral tothe essential job functions.



Qualifications

EDUCATION

  • Bachelor'sdegree in behavioral science or related health care field with a clinical focus 

EXPERIENCE

  • Aminimum of 1 year clinical experience in a physical rehabilitation setting/organization or 2 years experience in another related health care setting orany combination of the two.

LICENSE/CERTIFICATION

  • CRC,LMSW or CIRS certified or eligible, and current CPR certification