Triage Access Case Manager Admissions

Atlanta, GA - USA

Monthly Salary: Not Disclosed

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

About Shepherd Center

With five decades of experience Shepherd Center provides world-class clinical care research and family support for people experiencing the most complex conditions including spinal cord and brain injuries multi-trauma traumatic amputations stroke multiple sclerosis and pain. An elite center ranked byU.S. Newsas one of the nations top hospitals for rehabilitation Shepherd Center is also recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems. Shepherd is the only rehabilitation facility in the nation with an intensive care unit on-site allowing us to care for the most complex patients and begin the rehabilitation process sooner. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.

Shepherd Centers culture is one of hope humor and hard work. You will enjoy career growth strong relationships with co-workers strong support from leadership and fun activities that have kept over 12% of staff members working at Shepherd for more than 20 years.

The Triage Access Case Manager (ACM) screens all incoming referrals for new prospective admissions identifying patients as pre-determined appropriate for further evaluation by ACM for admission to facilitate the patient approval process. This role also assists in creating opportunities of care to a larger audience.

The Triage ACM performs several duties in order to facilitate the patient approval process.
Job Responsibilities:

o Reviews all referrals transmitted via Faxcom and online referral systems (including Epiccare Link NaviHealth Careport Aidin Ensocare etc).

o Determines the patients clinical appropriateness for evaluation and open cases for evaluation for patients that meet admission criteria.

o For patients approved for evaluation creates a new patient record in Epic sends patients medical records to HIM enters the required patient insurance information and sends for Benefit Verification.

o For patients not approved for evaluation opens and closes a non-admit case in Epic.

o Works in conjunction with the Clinical Access Manager to move patients through the admission review process as expeditiously as possible.

o Communicate with referring partners throughout the referral process

o Practices proper safety techniques in accordance with Center and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents or other safety issues to the supervisor and in the occurrence notification system.

o Monitors and ensures compliance with all regulatory requirements organizational standards and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process.

Required Minimum Education

o Bachelors degree (allied health nursing or related field) or appropriate state licensure.

Required Minimum Certification/Licensure:

o Certification in Case Management (Case Management Society of America American Case Management Association American Nurses Credentialing Center or equivalent certification within two years of position start date. Individuals hired prior to October 1 2022 are grandfathered in and must obtain their CCM or ACM within two years from October 1 2022.

o Licensed (PT OT SLP RN Licensed Social Worker Respiratory Therapist or Certified Recreational Therapist) or appropriate advanced degree.

Required Minimum Experience:

o Minimum of two (2) years broad clinical experience. Experience in care coordination case management discharge planning and utilization review preferred.

Required Minimum Skills:

o Effectivetime management skills.

o Excellent communication skills both verbal and written.

o Effective decision making/problem-solving skills and creativity in problem solving.

o Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs.

o Understanding of the interdisciplinary team approach and rehabilitation environment.

o Moderate to expert computer skills.

o Working knowledge of financial aspects of third-party payors and reimbursement

Physical Demands:

o Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time or exerting up to 15 pounds of force occasionally or a negligible amount of force frequently to lift carry push pull or otherwise move objects including the human body.

WORKING CONDITIONS

o No potential for exposure to blood and body fluids

Required Minimum Education

Bachelors degree (allied health nursing or related field) or appropriate state licensure.

Required Minimum Certification:

Certification in Case Management (Case Management Society of America American Case Management Association American Nurses Credentialing Center or equivalent certification within two years of position start date. Individuals hired prior to October 1 2022 are grandfathered in and must obtain their CCM or ACM within two years from October 1 2022.
Appropriate (PT OT SLP RN Licensed Social Worker Respiratory Therapist or Certified Recreational Therapist) or appropriate advanced degree.

Required Minimum Experience:

Minimum of two (2) years broad clinical experience. Experience in care coordination case management discharge planning and utilization review preferred.

Required Minimum Skills:

Effectivetime management skills.
Excellent communication skills both verbal and written.
Effective decision making/problem-solving skills and creativity in problem solving.
Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs.
Understanding of the interdisciplinary team approach and rehabilitation environment.
Moderate to expert computer skills.
Working knowledge of financial aspects of third-party payors and reimbursement

Preferred Qualifications:

Physical Demands:

Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time or exerting up to 15 pounds of force occasionally or a negligible amount of force frequently to lift carry push pull or otherwise move objects including the human body.

WORKING CONDITIONS

No potential for exposure to blood and body fluids

Required Experience:

Manager

About Shepherd CenterWith five decades of experience Shepherd Center provides world-class clinical care research and family support for people experiencing the most complex conditions including spinal cord and brain injuries multi-trauma traumatic amputations stroke multiple sclerosis and pain. An e...

About Shepherd Center

The Triage ACM performs several duties in order to facilitate the patient approval process.
Job Responsibilities:

o Reviews all referrals transmitted via Faxcom and online referral systems (including Epiccare Link NaviHealth Careport Aidin Ensocare etc).

o Determines the patients clinical appropriateness for evaluation and open cases for evaluation for patients that meet admission criteria.

o For patients approved for evaluation creates a new patient record in Epic sends patients medical records to HIM enters the required patient insurance information and sends for Benefit Verification.

o For patients not approved for evaluation opens and closes a non-admit case in Epic.

o Works in conjunction with the Clinical Access Manager to move patients through the admission review process as expeditiously as possible.

o Communicate with referring partners throughout the referral process

Required Minimum Education

o Bachelors degree (allied health nursing or related field) or appropriate state licensure.

Required Minimum Certification/Licensure:

o Licensed (PT OT SLP RN Licensed Social Worker Respiratory Therapist or Certified Recreational Therapist) or appropriate advanced degree.

Required Minimum Experience:

o Minimum of two (2) years broad clinical experience. Experience in care coordination case management discharge planning and utilization review preferred.

Required Minimum Skills:

o Effectivetime management skills.

o Excellent communication skills both verbal and written.

o Effective decision making/problem-solving skills and creativity in problem solving.

o Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs.

o Understanding of the interdisciplinary team approach and rehabilitation environment.

o Moderate to expert computer skills.

o Working knowledge of financial aspects of third-party payors and reimbursement

Physical Demands:

WORKING CONDITIONS

o No potential for exposure to blood and body fluids

Required Minimum Education

Bachelors degree (allied health nursing or related field) or appropriate state licensure.

Required Minimum Certification:

Certification in Case Management (Case Management Society of America American Case Management Association American Nurses Credentialing Center or equivalent certification within two years of position start date. Individuals hired prior to October 1 2022 are grandfathered in and must obtain their CCM or ACM within two years from October 1 2022.
Appropriate (PT OT SLP RN Licensed Social Worker Respiratory Therapist or Certified Recreational Therapist) or appropriate advanced degree.

Required Minimum Experience:

Minimum of two (2) years broad clinical experience. Experience in care coordination case management discharge planning and utilization review preferred.

Required Minimum Skills:

Effectivetime management skills.
Excellent communication skills both verbal and written.
Effective decision making/problem-solving skills and creativity in problem solving.
Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs.
Understanding of the interdisciplinary team approach and rehabilitation environment.
Moderate to expert computer skills.
Working knowledge of financial aspects of third-party payors and reimbursement

Preferred Qualifications:

Physical Demands:

Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time or exerting up to 15 pounds of force occasionally or a negligible amount of force frequently to lift carry push pull or otherwise move objects including the human body.

WORKING CONDITIONS