At UCHealth, we do things differently We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve.As Colorado's largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it's a passion. Summary -- Rehab PPS Case Manager - Rehabilitation Patient Care Unit - Memorial Central Hospital, Colorado Springs, CO Coordinate the care of the acute rehabilitation inpatient through the continuum of rehab care beginning with the admission screening process through discharge from the inpatient rehabilitation facility. Provide pre- authorization as well as ongoing authorization of stay with payors. Act as liaison to internal and external customers, and facilitate communication of appropriate services. Coordinate documentation for regulatory compliance in the Prospective Payment System. Coordinate the process of planning, organizing and coordinating services and resources for the acute inpatient rehabilitation patient during the inpatient stay and in preparation for discharge.
Coordinate the screening and admission process for the Inpatient Rehabilitation Facility (IRF). Ensure compliance with all regulations governing admission to IRF.
Collaborate with IRF Medical Director or designee on potential admissions to the IRF and perform ongoing case management and utilization review. Perform rounds at the system facilities and act as a consultant to multi-disciplinary team members regarding rehabilitation program benefits, services, and federal admission criteria. Engage and educate potential customers and referring providers by sharing knowledge of the service. Participate in marketing strategies for the IRF.
Present the IRF in a customer-friendly way. Serve as consultant with a focus on the client's rehabilitation potential, discharge plan, and feasibility for admission to the IRF. Collaborate with internal and external case management team members to provide recommendations for the most cost effective and appropriate level of care. Provide discharge planning case management duties as well as ongoing utilization review of the IRF patient record to ensure the appropriate and authorized level of care is provided during the stay and arranged for at the time of discharge. Maintain a thorough knowledge of the current IRF regulatory requirements and outcomes of the program.
Share knowledge with colleagues and other healthcare providers. Oversee and ensure the timely completion and submission of all regulatory data for IRF patients including the IRF Patient Assessment Instrument. Present weekly profile reports for all IRF patients to the interdisciplinary team of the IRF. Actively participate in team conferences and provide documentation for and direction to the team in order to ensure regulatory compliance. Facilitate and communicate the discharge plan with patient/family and healthcare team. Perform concurrent compliance audits on admitted IRF patients in order to ensure clinical, medical, and financial appropriateness. Communicate with and provide feedback to the coding team to ensure accuracy. Provide timely clinical medical reviews to all payors as needed and facilitate financial coverage of the IRF stay to avoid denials of coverage. Communicate with patients/families and healthcare on the plan. Plan, implement and communicate all arrangements for appropriate discharge.
Participate in the Medicare Mandatory Notification of Discharge Rights. Assist with quality initiatives, audits, and other compliance issues as directed. Work with IRF leadership and team members to monitor trends and facilitate process improvements. Monitor and report outcomes, trends, and benchmark data for IRF initiatives to leadership and team members. Maintain regulatory databases and assist with annual compliance document submission. Provide ongoing education to the IRF team members to ensure accurate documentation of Functional Independence Measure (FIM) for data submission. Maintain clinical competence. Assist as needed in patient care delivery according to rehab standards and age appropriate care.
Provide excellent customer service through prompt and thoughtful assistance to patients and families utilizing the principles of patient and family-centered care. Protect confidential information in accordance with policies and procedures. Participate in continuous process improvement when appropriate. Create efficiencies utilizing the PDCA and Lean processes.
Bachelor's degree in Nursing, Physical Therapy, Occupational Therapy or Speech Therapy required.
3 years of clinical experience in an acute rehabilitation setting.
Current Colorado license to practice as Registered Nurse, Physical Therapist, Occupational Therapist or Speech Language Pathologist. Relevant life support certification as defined by unit certification list.
IF APPLICABLE: BLS through the American Heart Association or the American Red Cross CPR for the Professional Rescuer with card in-hand before start date.BLS or CPR card must be good through sixty days of hire.All life support certification cards must be issued by either the American Heart Association or the American Red Cross CPR for the Professional Rescuer. (American Red Cross for the Professional Rescuer is only good upon hire and all renewals will need to be through an American Heart Association sanctioned course.)
IF APPLICABLE: Due to Point of Care Testing duties associated with this position, upon hire, a copy of highest level of education (diploma, degree, or transcripts) would be required to present to the hiring manager.If this is available to you at this time, please attach it with your resume in one document.
Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy.We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we'll do everything in our power to make sure you grow and have a meaningful career. There's no limits to your potential here. Be Extraordinary. Join Us Today! The University of Colorado Health (UCHealth) system recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution.As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements.No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status.UCHealth does not discriminate against any "qualified applicant with a disability" as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.
With award-winning hospitals and facilities serving the entire Front Range, University of Colorado Health is the state’s largest and most innovative health system. By integrating the strengths of academic medicine with the finest community health care, we’re able to push the boundaries of medicine and offer our employees endless career opportunities. Here, there are no limits, except those you pla...ce on yourself. Everyone is united by their passion for discovery and their commitment to improving patients’ lives.