Rehab PPS Case Manager

Description

Facility: Poudre Valley Hospital
Department: Acute IP Rehab Support

Work Schedule: PRN Days

Coordinates the care of acute rehabilitation inpatients. Provides pre-authorization and authorization of stay. Facilitates communication of services. Coordinates documentation for regulatory compliance in the Prospective Payment System (PPS).

Responsibilities:

• Coordinates screening and admission process for the Inpatient Rehabilitation Facility (IRF). Ensures compliance with regulations. Performs case management and utilization review as needed. Performs rounds and acts as a consultant to staff.
• Educates potential patients and referring providers. Collaborates with staff to provide the most cost effective and appropriate level of care. Performs discharge planning case management duties and utilization review as directed.
• Ensures timely completion and submission of all regulatory data. Presents profile reports. Facilitates discharge plans with patient, family and healthcare team. Performs compliance audits to ensure clinical, medical, and financial appropriateness. Works with coding team to ensure accuracy.
• Provides timely clinical medical reviews to all payors as needed and facilitates financial coverage of stay to avoid denials of coverage. Participates in the Medicare Mandatory Notification of Discharge Rights. Reports on outcomes, trends, and benchmark data. Maintains regulatory databases and assists with annual compliance document submission. Educates staff on documentation of Functional Independence Measure (FIM).

Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements:

Minimum Required Education: Bachelor's degree in Nursing or Physical, Occupational, or Speech Therapy. Preferred: MSN, Rehabilitation nursing certification.
Required Licensure/Certification: State licensure as a Registered Nurse (RN), Physical Therapist, Occupational Therapist or Speech Language Pathologist. Relevant life support certification as determined at position level.
Minimum Experience: 3 years of clinical experience in an acute rehabilitation setting.

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.)

Are you a RN New Grad? Visit https://www.uchealth.org/professionals/residencies/ to find out about our exciting New Grad opportunities!

The pay range for this position is: $36.19 - $54.28 / hour. Pay is dependent on applicant's relevant experience.

UCHealth offers a Five Year Incentive Bonus to recognize employee’s contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years’ employment.

UCHealth offers their employees a competitive and comprehensive total rewards package:

• Full medical, dental and vision coverage
• Retirement plans to include pension plan and 403(b) matching
• Paid time off. Start your employment at UCHealth with PTO in your bank
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition and continuing education reimbursement
• Wellness benefits
• 5 year incentive bonus
• Full suite of voluntary benefits such as identity theft protection and pet insurance
• Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may also qualify for up to $5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year
  

Loan Repayment:

UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.

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.

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!

UCHealth 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.