Meets with patient upon admission to discuss rehabilitation process and role of manager/case manager in individual's program.
Communicates effectively and responds to patient, families, visitors, staff and physicians, in a courteous, pleasant manner; contributes to an environment conducive to open, direct lines of communication.
Conducts and documents initial patient assessment within 48 hours to include psychosocial, family and disposition status; determines tentative, initial discharge plans in conjunction with patient and family goals. Appropriately modifies approach to the patient based upon patient's age and developmental level.
Involves the patient/family in the development of the plan of care by obtaining their goals for
Reviews goals with patient's family and third party payor. Maintains accurate up-to-date documentation in the medical records of patient and family contacts, communications with payors and other services performed on behalf of patient and family.
Coordinates, evaluates, documents and reviews interdisciplinary team goals ensuring appropriate medical records sent to family, appropriate physicians and external case managers when necessary.
Leads/Co-Leads team conferences. Documents in the medical record a summary of the team conference. Serves as the primary family contact for the treatment team, communicating within 24 hours of the care conference. Also updates external case manager and/or payor source regarding progress, plan and patient's future needs (within 24 hours of staffing or as requested by payor sources).
Ensures the scheduling of family conferences, family participation in therapy and provides pertinent information to appropriate team members. Documents in the medical record a summary of the family conference.
Coordinates completion of discharge plans by assisting with arrangements for family education, equipment, and services as appropriate for patient discharge level of care.
Calls patient or family within established time frame post-discharge to ensure planned discharge recommendations are occurring and to assess if additional services are needed.
In conjunction with the Controller, monitors and ensures discount of per diem negotiations, recertification concurrent reviews and timely reports.
Participates in monitoring, analyzing and utilizing program evaluation data to promote quality of care, increase marketing activity and to position hospital for success.
Maintains good working relationships with other hospital departments, participates in hospital meetings and serves on hospital committee as requested.
Responsible for ensuring that all necessary communication between referral sources and the facilities occurs in a timely manner.
Participates in local professional organizations.
Maintain records, data, etc., to be used for teaching, trending, etc.
Analyze and utilize historical data and for information from tracking systems to manage efforts and position network for success.
Adheres to dress code, appearance is neat and clean.
Maintains regulatory requirements, including all state, federal and Joint Commission regulations.
Maintains and ensures patient confidentiality at all times.
Reports to work on time and as scheduled.
Wears identification while on duty.
Attends departmental in-services and completes annual competencies/education requirements.
Works at maintaining a good rapport and a cooperative working relationship with physicians, departments and staff.
Represents the organization in a positive and professional manner.
Complies with policies and procedures regarding department operations, fire, safety, infection control and emergency management.
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.
Performs other duties as assigned.
Adheres to Patients Bill of Rights.
Recognizes problems and assumes responsibility for helping to solve them when they occur.
Seeks supervisory help appropriate in problem solving and assists in implementing solutions.
Ensures patients have a good understanding of their insurance benefits and answers questions as needed.
Consistently demonstrates the ability to organize tasks in order of priority.
Consistently performs job duties in an independent manner with minimal direct supervision required.
Performs other duties as requested by authorized personnel or as necessary for effective operation of the facility, including emergency situations.
Maintains up-to-date statistical data in computer information system within established time frames.
Compiles weekly and monthly statistics for discharges to community vs. SNFs.
Prepares statistics for corporate report as designated.
Maintains regulatory requirements, including all state, federal, Joint Commission and Hospital Compliance Plan.
Maintains cooperative working relationship and good rapport with Medical Staff, hospital departments and staff and other organizations or entities related to the hospital business.
Represents the organization in a positive and professional manner.
Communicates the mission, ethics and goals of the organization at all levels of the organization.
Ability to clearly and effectively communicate with all constituents (patients, families, peers, and other healthcare team members) as needed for leadership, assessment, intervention, and professional development.
Follows hospital and departmental policy and procedure for attendance including reporting to work, use of sick leave, vacation, break time, etc.
Performs other duties as requested by authorized personnel or as necessary for effective operation of the facility.
Maintains current license to practice professional nursing in the state of Ohio, if applicable.
Actively identifies and participates in training, education and developmental activities to improve own knowledge and performance.
Attends and participates in annual mandatory inservices and maintains current CPR certification.
Demonstrates positive attitude toward work and the workplace and behavior that supports administrative and facility decisions; creates atmosphere of mutual trust, harmony, acceptance and respect within the hospital community.
Current MSW in Social Work, Psychology, Sociology or Registered/Licensed Nurse licensure in Ohio.
Minimum of 2 years social work or case management experience; acute/rehabilitation hospital experience preferred.
Effective oral and written communication skills in English, additional languages preferred.
Basic computer skills required.
Must have good organizational 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.
Job : Case Mgmt/MDS Primary Location : OH-Beachwood-CHC Payroll - University Hospitals Rehab Organization : 6781 - CHC Payroll - University Hospitals Rehab Shift : Day