Triage Access Case Manager - Admissions

Shepherd Center • Atlanta, GA

22h

About The Position

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 by U.S. News as one of the nation’s 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 Center's 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.

Requirements

• Bachelor’s degree (allied health, nursing, or related field) or appropriate state licensure.
• 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.
• Licensed (PT, OT, SLP, RN, Licensed Social Worker, Respiratory Therapist or Certified Recreational Therapist) or appropriate advanced degree.
• Minimum of two (2) years broad clinical experience. Experience in care coordination, case management, discharge planning and utilization review preferred.
• Effective time 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

Nice To Haves

• N/A

Responsibilities

• Reviews all referrals transmitted via Faxcom and online referral systems (including Epiccare Link, NaviHealth, Careport, Aidin, Ensocare, etc).
• Determines the patient's clinical appropriateness for evaluation and open cases for evaluation for patients that meet admission criteria.
• 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.
• For patients not approved for evaluation, opens and closes a non-admit case in Epic.
• Works in conjunction with the Clinical Access Manager to move patients through the admission review process as expeditiously as possible.
• Communicate with referring partners throughout the referral process
• 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.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level