Job Summary
The role focuses on orchestrating interdisciplinary care and planning for patient discharges. It involves identifying obstacles to patient progress and documenting care activities in line with CMS standards.
Responsibilities
- Coordinate and manage interdisciplinary care and discharge planning for patients.
- Identify and address barriers impacting patient progress.
- Document care activities consistently following CMS guidelines.
- Facilitate team conferences and engage in family meetings.
- Communicate patient progress and discharge plans to caregivers.
- Collaborate on Case Mix Group and comorbidity review processes.
Qualifications
- Must possess an active license as a Registered Nurse (RN), social worker (LSW), respiratory therapist, physical therapist (PT), occupational therapist (OT), or speech-language pathologist (SLP).
- A minimum of two years of experience in inpatient case management or social work is required.
- Experience in rehabilitation is highly preferred.
- Strong skills in communication, organization, and collaboration are essential.
- Proficiency in Microsoft Office Suite is expected.
- Case management or rehabilitation nursing certification is preferred.
