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Kindred Healthcare Operating LLC Case Manager Hospital in Avon, Ohio

Description UH Avon Rehabilitation Hospital is proud to be recognized by Newsweek as one of America's Best Rehabilitation Hospitals in 2021. UH Avon Rehabilitation Hospital is a joint venture between University Hospitals and Kindred Healthcare, bringing together the expertise of both world-class organizations. Opened in January 2016, UH Avon Rehabilitation Hospital is focused on improving the functional status of our patients after an injury or illness with the goal of returning our patients home safely.JOB SUMMARY:Coordinates management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management and discharge planning.Provides ongoing support and expertise through comprehensive assessment, care coordination, plan implementation and overall evaluation of individual patient needs while ensuring patient preferences. Serves as a patient advocate through resource utilization, discharge planning and addressing the holistic needs of the patient. The Case Manager (CM) is responsible for providing care coordination including needs assessment and identification of care options, communication with patients and families in an interdisciplinary environment consistent with the position's qualifications, professional practices and ethical standards. The CM shall be accountable for carrying out all responsibilities in accordance with Kindred Healthcare CORE values.Promotes the hospital's mission, vision, and values.ESSENTIAL FUNCTIONS:Completes departmental orientation, initial and annual competencies. Assists with departmental specific performance improvement initiatives collecting and reporting data as requested by supervisor.As appropriate, consults other departmental staff to collaborate in patient care delivery, identify barriers to care and or discharge and develop solutions/resolution.Completes documentation per workflow timeline and content requirements including completion of the Individual Plan of Care (IPoC) 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. Communicates effectively with nursing, therapy and other ancillary departments to ensure proper utilization.If no Lead Case Manager, the CM participates as the facility representative for national CM Conference calls and communicates new information to the facility CMs.Assists with concurrent and retrospective utilization review activities including denials and appeals. Works with physicians to conduct peer review with payer medical director when indicated. Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech.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, di

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