Address
Form of workNew Transitional Care Program: New multi-discipline program within the SNF setting specifically created to help persons with spinal cord injuries and head injuries to achieve a higher level of independent functioning in daily living skills through skilled nursing care, rehabilitative services, case management, and psychological services.
Reporting to the Manager of Transitional Care, the Case Manager has the responsibility for facilitating patient care by assessing patient needs, evaluating treatment options, creating longitudinal care plans, and coordinating care to ensure effective treatment within workers compensation patient population. A successful Case Manager will guarantee smooth and efficient transition to next setting of care.
Job Responsibilities:
- Determine patient care needs through evaluation and assessment.
- Complete regular educational sessions with patients and families to ensure their needs are being met and questions are being answered.
- Developing longitudinal care plan
- Monitoring, and evaluating longitudinal plan and progress
- Ability to facilitate complex cases with creative resource planning
- Assisting patients and families to make informed decisions by acting as their advocate regarding their clinical status and treatment options.
- Facilitate interdisciplinary approach and ensure discharge plans are on track
- Maintain documentation requirements
- Preparing patients for discharge by reviewing care needs, coordinating discharge and post discharge requirements
- Responsible for all post discharge services, appointments, and DME.
- Facilitate patient access to community resources
- Continuously learn about resources for patients and families
- Responsible for team conference documentation and compliance
- Responsible for providing a positive patient experience through compassion and communication
- Serve the liaison between the Brooks Case Managers at all settings and the workers compensation reps
- Implements external marketing activities to promote programs/services to community agencies, insurance companies, hospitals, physicians, private rehabilitation providers, and prospective clients
- Consults with physicians, social workers/discharge planners in all levels of care in reference to patients' rehabilitation potential and earlier transfers to rehabilitation center if medically stable
- Initiates treatment planning process by identifying necessary services, funding and treatment options and long-term goals as expressed by the patient/family.
- Performs clinical, psychosocial, and benefits/resources assessments for referred patients, to evaluate for admission. (Pre-admission screening)
- Effective communication and excellent organizational skills
- Ability to problem solve
- Computer proficiency
Job Qualifications:
- Licensed Nurse (RN, BSN, MSN) or RN CCM with bachelor's degree as a minimum
- Two years experience as a Case Manager required
- One year experience working with workers compensation preferred
Thriving in a culture that you can be proud of, you will also receive many employee benefits such as the following:
- Competitive Pay
- Comprehensive Benefits package
- Vacation/Paid Time Off
- Retirement Plan with Match
- Employee Discounts
- Clinical Education and Professional Development Programs
For more than 50 years, the nonprofit Brooks Rehabilitation, headquartered in Jacksonville, Fla., has been a comprehensive system of care for physical rehabilitation. Ranked as the No. 1 rehabilitation hospital in Florida and one of the top 20 in the nation on U.S. News & World Report, Brooks operates two inpatient rehabilitation hospitals in Jacksonville, Fla., and a Center for Inpatient Rehabilitation in partnership with Halifax Health (Daytona Beach). Brooks also offers one of the region's largest home healthcare agencies; more than 50 outpatient therapy clinics; the Brooks Rehabilitation Medical Group; two skilled nursing facilities; assisted living; memory care; and the Clinical Research Center, which specializes in advanced research to further the science of rehabilitation. In addition, Brooks provides many low- or no-cost community programs and services to improve the quality of life for people living with physical disabilities.
