MadisonRecruiter Since 2001
the smart solution for Madison jobs

Lead Case Manager

Company: UW Health Rehabilitation Hospital
Location: Madison
Posted on: September 19, 2023

Job Description:

DescriptionWhat makes UW Health Rehab Hospital a great place to work?---- Our--PEOPLE, of course!
We answer the call because we have a fundamental need to help people. In return, we get to work in an environment with leaders who strive to optimize job effectiveness, assure positive experiences and job satisfaction.
Your career growth begins when you join an interdisciplinary team, where doctors, nurses, therapists and other experts work together to form individualized care plans for our patients. Opportunities through our continuing education programs, apprenticeship programs, and tuition reimbursement programs, not only allow for continual career growth but emphasize our commitment to investing in our employees and developing future healthcare leaders.
UW Health Rehabilitation Hospital--is a free-standing, 50-bed acute inpatient rehabilitation facility located on the east side of Madison, Wisconsin.---Our hospital offers specialized rehab programs for people who have experienced stroke, brain and spinal-cord injuries, amputations, complex orthopedic injuries and many other conditions. We create individualized plans of care that address both intense rehab and acute medical needs.---Our goal is to help patients achieve their highest level of function and return home as soon as possible. The UW Health Rehabilitation Hospital is a partnership between UW Health, Unity Point-Meriter and Kindred Healthcare.
Why work at UW Health Rehab Hospital?-- Be part of a team recognized by--Newsweek--as one of America's Best Rehabilitation Centers dedicated to patient hope, healing, and recovery.
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.
Assists/trouble shoots difficult discharge planning/placement cases.
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.
  • Current Registered--Nurse--or Social Work licensure in the State of WI.
  • Certification in Case Management or Rehabilitation Nursing 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

Keywords: UW Health Rehabilitation Hospital, Madison , Lead Case Manager, Executive , Madison, Wisconsin

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Log In or Create An Account

Get the latest Wisconsin jobs by following @recnetWI on Twitter!

Madison RSS job feeds