Case Manager

Key responsibilities of the role:

• Lead the implementation and improvement of case management protocols within the Rehabilitation and Long-Term Care department.
• Develop and implement policies and procedures related to case management and care coordination in alignment with hospital standards and regulatory requirements.
• Collaborate with the finance department to manage cost control, insurance pre-authorizations, and reimbursement processes.
• Ensure accurate documentation of patient care plans, discharge summaries, and case management records.
• Participate in budget planning and resource allocation specific to rehabilitation and long-term care services.
• Oversee the development of individualized care plans that align with medical, psychological, and social needs of long-term and rehabilitative patients.
• Act as a liaison between patients, families, physicians, nursing, allied health professionals, and external care agencies.
• Supervise a multidisciplinary team of case coordinators, social workers, and administrative support personnel.
• Assess and evaluate patient needs upon admission, during stay, and at discharge to develop individualized care plans in collaboration with physicians, therapists, nurses, and social workers.
• Manage lengths of stay and resource allocation effectively to optimize bed occupancy and operational efficiency.
• Coordinate with insurance providers and billing departments for authorization and reimbursement processes.
• participate in clinical audits, risk management, and continuous quality improvement initiatives related to rehabilitation and long-term care services.
• Perform other applicable tasks and duties within the realm of his/her knowledge, skills and abilities.
• Ensure adherence to hospital policies, Saudi health regulations, and international best practices for quality and safety in rehabilitation and long-term care.
• Participate in the development, implementation, and evaluation of quality improvement initiatives and safety protocols.
• Monitor and report on patient safety incidents, adverse events, and outcomes related to rehabilitation and long-term care services.
• Conduct regular audits and compliance checks related to case management and care standards.
• Advocate for patient rights and ensure culturally sensitive care aligned with Saudi Arabian norms and patient preferences.
• Educate patients and families on care plans, safety practices, and rehabilitation goals to empower informed decision-making.

Qualifications, Certifications and Experience:

• Bachelor’s degree in Case Management, Nursing, Social Work, Healthcare Administration, or related health sciences field is required.
• Strong knowledge of rehabilitation and long-term care principles.
• Excellent communication, negotiation, and interpersonal skills.
• Ability to work effectively within a multidisciplinary team.
• Proficient in medical documentation and electronic health records.
• Sound decision-making and problem-solving abilities.
• Familiarity with Saudi healthcare regulations and cultural considerations.
• Ability to manage multiple cases and priorities efficiently.