CASE MANAGER – CBRF

The Case Manager at our Community-Based Residential Facility (CBRF) plays a crucial role in overseeing the health and well-being of our residents. This position involves comprehensive case management, including assessment, planning, coordination, monitoring, and evaluation of health care services as well as ensures that our residents receive personalized and effective health care in line with our facilitys standards and regulatory guidelines.

Key Responsibilities:

1. Assessment and Planning:

Conduct comprehensive assessments of residents health status, including physical, psychological, and social aspects.

Develop and implement individualized service care plans in collaboration with residents, their families, care team, and other healthcare professionals.

2. Case Management:

Coordinate and monitor the implementation of care plans, adjusting as necessary based on changes in residents conditions.

Facilitate communication between residents, families, care teams, and healthcare providers to ensure an integrated approach to health care.

Maintains an awareness of funding source needs and status, communicates to all involved parties, and initiates actions to maintain funding for services at all phases of treatment.

3. Healthcare Coordination:

Liaise with external healthcare providers for specialized care and arrange for residential admissions or referrals as needed.

4. Documentation and Compliance:

Maintain accurate and up-to-date records of residents health status, treatments, and progress.

Ensure compliance with healthcare standards and regulatory requirements specific to CBRFs (DHS 83).

5. Team Collaboration:

Work closely with a multidisciplinary team to provide holistic care.

Participate in team meetings and contribute to continuous quality improvement initiatives.

Actively participates in resident activities and outings, including but not limited to coordination and driving.

To assess, direct, and intervene in crisis situations using facility-approved crisis management strategies and techniques.

To actively participate in treatment team decisions, collecting data, assessing resident needs, designing and implementing programs, and documenting and evaluating resident responses.

Adheres to safe work practices consistent with Lakeview’s mission, Medical Staff Bylaws, Administrative, Clinical, and Human Resources policies and procedures. Actively supports the mission, vision, and goals of the program.

Completes other duties as assigned in a timely manner.

6. Resident and Family Support:

Provide education and support to residents and their families regarding health conditions, treatment plans, and healthy lifestyle choices.

Address concerns and answer questions to ensure a clear understanding of care plans.

Qualifications:

Education:

LPN or RN required.

Experience:

Experience in case management, preferably in a CBRF or similar setting.

One year experience in rehabilitation services or related field.

Experience serving needs of persons with neurological and/or physical impairments.

Experience in professional communication including facilitating meetings, report writing, and medical record documentation. Able to manage and prioritize multiple tasks in an independent fashion.

Strong clinical skills with the ability to assess and respond to the needs of disabled residents.

Knowledge of appropriate nursing assessment, diagnosis, evaluation, and intervention with CBRF residents. Knowledge of milieu management.

Ability to delegate responsibility to other staff and monitor their performance.

Skill in developing therapeutic relationships with residents and their families. Skills in initiation and ongoing documentation on , progress summary, nursing care plans, and Individualized Service Plans.

Ability to utilize a resident-care focused approach. Ability to handle stressful situations in a calm and professional manner.

Effective communication skills, both verbal and written.

Valid driver’s license and good driving record

About Lakeview Specialty Hospital & Rehab:

Lakeview Specialty Hospital and Rehab is a Joint Commission Accredited and licensed long term acute care hospital (LTACH) and Inpatient Rehabilitation Hospital (IRF) that has delivered 30 years of innovative programs and extensive services with expertise in medically complex care, neurobehavioral health, rehabilitation, and community supportive living. With superior proficiency in brain injury, rehabilitation and complex respiratory care we are able to help our patients with difficult medical conditions reach their highest level of healing and functional independence possible. Located on more than 80 acres in a rural community outside of Milwaukee in Waterford, Wisconsin. Our peaceful grounds, coupled with tenured, talented and caring staff, lend to the healing and recovery process.