Description
JOB PURPOSE OR MISSION: Provide case management services to all patients at a level consistent with Baton Rouge Rehabilitation Hospital (BRRH) mission, vision, and values.
JOB FUNCTIONS
ESSENTIAL JOB FUNCTIONS include, but are not limited to:
1. Functions as the interdisciplinary team coordinator to ensure the timely provision of cost-effective quality care.
PERFORMANCE STANDARDS:
• Completes initial patient assessment within established time frames, to include psychosocial, family and discharge disposition status.
• Monitors for quality and type of services delivered to patients, ensuring management within established parameters.
• Actively participates with other members of the healthcare team in the development and implementation of plan of care.
• Reviews evaluation, goals and updates of plan of care with patient and/or family.
• Appropriately assesses the need for and arranges financial resources for the patient, including federal, state and local programs.
• Identifies and refers problem cases to Utilization Review Committee and/or Medical Director.
• Communicates pertinent clinical information with payer within correct timeframes.
• Leads/co-leads team conferences. Documents discussion of progress, attainment of goals or changes to goals.
• Maintains patient rights and acts as patient advocate.
• Coordinates discharge plan by assisting with arrangements for family education, equipment, continued therapy and other services as appropriate
• Works cooperatively by collaborating with team members to assure a comprehensive interdisciplinary patient program.
• Is present, prepared, and participatory for interdisciplinary team conferences, patient related conferences and meetings.
• Provides age specific direct and indirect patient care for school age (6-12), Adolescent (12-18) adult (18-65) and elderly (65+)
2. Documents care provided
PERFORMANCE STANDARDS:
• Maintains progress notes on a per contact basis to include documentation of team conferences, family conferences, patient/family interaction, patient account concerns, etc.
• Assists physician and interdisciplinary team with supporting documentation for coding and authorization, in order to avoid denial of payment.
• Upholds ethical principles via accurate documentation.
3. Maintains compliance.
PERFORMANCE STANDARDS:
• Follows the Code of Conduct, Conflict of Interest, Medicare, Joint Commission Guidelines, and policies and procedures.
• HIPAA: Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: Medical records w/o limitation both paper and
electronic, patient demographics, lab and radiology results, patient information related to surgery or appointment schedules, information related to patient location, religious beliefs and/or public health records, medical records related to quality/data, patient financial information and/or 3rd party billing, patient-related complaints, and research information.
• Ensures that team conferences are performed within seven days of admission and once a week thereafter until discharge.
• Ensures the plan of care is individualized, complete and signed within four days of admission.
• Ensures team conference notes have an estimated discharge date, assess patient's progress toward goals, consider possible resolutions to any barriers, reassess validity of rehabilitation goals, monitor and revise treatment plan and indicate measurable improvement.
• Ensures a physician, nurse, case manager and all licensed therapists involved in treating the patient are present or represented in the conference and all signatures are documented.
4. Participates in performance improvement.
PERFORMANCE STANDARDS:
• Actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.
• Offers suggestions for process improvement; recommends to the supervisor/manager equipment and/or supplies that may enhance our program.
• Meets facility goal for referring inpatients to outpatient services
5. Maintains patient and employee safety.
PERFORMANCE STANDARDS:
• Actively participates in and demonstrates effective patient and employee safety practices.
• Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: Incident reporting, handling of wastes, sharps and linen, PPE,
exposure control plans, hand washing, environment of care, patient identification, administers/receives patient orders, validates, transports, monitors or observes patients for procedures, and monitors clinical alarms.
• Reports on?any safety concerns and broken or malfunctioning equipment to supervisor, facilities maintenance or biomed in?a timely?manner
6. Other tasks
PERFORMANCE STANDARDS:
• Completes assigned projects by due date.
• Functions as a liaison to the referral source, community agency, etc. to facilitate communication regarding patient care.
• Actively participates in marketing opportunities for BRRH and maintains good public relations with community
• Works on holidays, weekends and during emergency situations as required to meet patient needs and maintain compliance with IRF guidelines.
• Utilizes KRONOS to request time-off and independently monitors timecard, benefits, and notifications.??
• Manages daily schedule considering patient needs, co-worker's schedules, and productivity.?
• Assists other departments as needed due to census, skill set, schedule etc.
• Volunteers for or participates when assigned in hospital teams, committees, projects and marketing.
7. Performs all other duties as assigned.
Requirements
Inpatient managed care setting- preferred
SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Bachelor's degree
Case Manager Certification (CCMS)
CPR Certified
Oral and written communication skills required.
Ability to work in an interdisciplinary environment.
Good organizational skills.
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