Community Rehabilitation Hospital North, located on the Community Hospital North medical campus and in partnership with Kindred Healthcare, is an inpatient facility that offers superior access and the latest equipment to improve the lives of individuals with a broad range of diagnoses - from brain and spinal cord injury to stroke and amputation.
Our 63,000 square foot facility has 60 beds and serves as a Midwestern regional provider for patients with complex physical and neurological injuries and has an advanced accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) in Adult Inpatient Care and for their Inpatient Brain Injury Specialty Program, Stroke Specialty Program and Amputee Program as well as Joint Commission disease-specific certifications in Stroke and Amputee Rehabilitation.
Provides leadership for the case management team and oversees the hospital Case Management Department's daily activities. Coordinates the integration of Social Services/Case Management functions into the patient's care plan, and discharge planning processes and communicates as needed with hospital departmental staff, external service organizations and agencies, payers, and health care providers to ensure the patient's care needs are met. Facilitates team conference to help ensure care coordination throughout the patient's hospital stay and communicates with patient and patient's caregiver(s) as needed to ensure continuity of care, promote caregiver engagement and set expectations of length of stay and anticipated plan for discharge.
Provides ongoing support and expertise through comprehensive assessment, care coordination, plan implementation and overall evaluation of individual patient needs while ensuring patient preferences. Enhances the quality of patient management and experience, to promote continuity of care and cost effectiveness through the integration of case management functions. Serves as a patient advocate and performs ongoing staff education related to resource utilization, care coordination, discharge planning and psychosocial aspects of healthcare delivery.
Promotes the hospital's mission, vision, and values.
Oversees and directs the activities of the case management department including the completion of orientation, initial and annual competencies.
Responsible for annual performance reviews and ongoing job performance of all case management staff.
Responsible for facilitating the hospital's quarterly Utilization Management Committee ensuring compliance with CMS' Conditions of Participation
Responsible for leading and coordinating departmental specific performance improvement initiatives and reports all PI activities to the hospital's Quality Improvement Committee.
As appropriate, consults other departmental staff to collaborate in patient care delivery, identify barriers to care and or discharge and develop solutions/resolution.
Ensures case management documentation is completed and thorough per workflow timeline requirements including completion of the Individual Plan of Care (IPoC) as per CMS guidelines.
Schedules family conferences and/or communicates with caregiver following each team conference and more often as needed to keep patient and designated caregiver informed of progress and provides appropriate information related to goal achievement, course of rehabilitation stay, and plans for discharge.
Coordinates weekly patient care team conferences to facilitate development, monitoring and refinement of treatment plan to achieve identified patient goals and outcomes.
Reviews the patient's assigned CMG and helps the team identify any potential missed comorbid conditions that are actively being treated during the patient's stay. Communicates any findings to the HIM team.
Participates as the facility representative for national internal CM Conference calls and communicates new information to the facility CMs.
Supervises employees involved in concurrent and retrospective utilization review activities including assisting with denials and appeals. Works with physicians to conduct peer review with payer medical director when indicated.
Communicates effectively with nursing, therapy and other ancillary departments to ensure proper utilization.
Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech.
Promotes and builds physician relations by developing strategic and operational programs and goals by maintaining availability and visibility with physicians and collaborating closely with physician advisors in case management activities
Coordinates discharge planning needs including but not limited to; home health services, physician follow up care, durable medical equipment, medical supplies, healthcare services, outpatient therapy, dialysis, skilled nursing care, assisted living care, hospice care, private duty care, etc. Responsible for coordinating all patient care needs prior to discharge ensuring a safe thorough discharge plan. Ensures patient choice is offered and documented as per CMS' Conditions of Participation for Discharge Planning.
Identifies trends that impact the quality, cost effectiveness, patient experience and delivery of care services and brings to hospital leadership meetings for discussion and action.
Performs intake assessment on patient within 24 to 72 hours of admission, preferably within 48 hours.
Performs follow-up assessments per Case Management Plan and/or hospital policy.
Demonstrates an ability to be flexible, organized and function under stressful situations.
Other duties as assigned.
Adheres to dress code, appearance is neat and clean and wears appropriate identification while on duty
Completes annual health, safety, and education requirements. Maintains professional growth and development.
Maintains confidentiality of all patient and/or employee information to assure patient and/or employee rights are protected.
Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served.
Reports to work on time as scheduled; adheres to policies regarding notification of absence.
Attends all mandatory in-services and staff meetings.
Represents the organization in a positive and professional manner.
Complies with all organizational policies regarding ethical business practices.
Communicates the mission, ethics, and goals of the hospital, as well as the focus statement of the department.
Maintains current licensure/certification for position, if applicable.
Consistently demonstrates Guest Relation's skills to patients, physicians, visitors, employees, and any other individuals with whom they may come in contact.
Consistently follows departmental and hospital Health, Safety, Security, Hazardous Materials policies and procedures.
HIPAA: Conduct job responsibilities in accordance with HIPAA privacy laws, follow hospital policy in provision of patient confidentiality. Able to identify patient confidentiality issues and reports to proper hospital personnel immediately.
Compliance: Conducts job responsibilities in accordance with standards set forth in Kindred's Code of Conduct, Kindred policy and procedures, applicable federal and state laws, and applicable standards.
Current Registered Nurse or Social Work licensure or Masters or Bachelors in Social Work as required in the state where the hospital is located (VERIFY STATE REQUIRMENT) OR Healthcare professional licensure as Respiratory Therapist, Physical Therapist, Speech Language Pathologist or Occupational Therapist.
Certification in Case Management or Rehabilitation preferred; for example, Commission for Case Manager Certification (CCM); Association of Rehabilitation Nurses (ARN) certification, American Case Management Association (ACM) or Board Certification in CM by the ANCC e.g.: RN-BC
Minimum of 2 years social work or case management experience in an inpatient setting highly preferred; acute/rehabilitation hospital experience preferred.
Previous leadership or supervisory experience strongly preferred.
Effective oral and written communication skills in English, additional languages preferred
Basic computer skills in excel, word, outlook, power point, etc. required.
Must have good organizational skills, time management skills and analytical ability in order to interpret information and carry out duties independently
Must be cooperative and have the desire to be a team player.
Must recognize and observe confidentiality principles.
Basic computer knowledge.
Knowledge of basic equipment.
Appropriate telephone communication skills.
Physical and Safety Requirements:
Good general health and stress coping ability. Full mobility and ability to participate in vigorous activity. Ability to clearly and effectively communicate with all constituents (patients, families, peers, and other healthcare team members) as needed for assessment, intervention, and professional development. Possess near vision acuity for accurate reading of equipment and recording on patient charts.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.
Job : Case Mgmt/MDS Primary Location : IN-Indianapolis-Community Rehabilitation Hospital North Organization : 4072 - Community Rehabilitation Hospital North Shift : Day