Rehabilitation Case Manager

6 months ago

Johannesburg, South Africa Rand Mutual Assurance Full time

**THE JOB AT A GLANCE**

To deliver coordinate case management: through the three pillars clinical rehabilitation, vocational rehabilitation, and social reintegration. Track progress of injured COID employees referred to RMA Rehab Team, liaise with therapy team, with the purpose of prevention of complications, and guide the process of restoration to independent living, and feasible work reintegration. Interface between employer members and healthcare system and/or community rehabilitation/ reintegration service providers.

**WHAT WILL YOU DO?**

**Clinical Rehabilitation Pillar Tasks**

Acute hospital case management:

- Receive referral acute reports from HUM, be able to interpret clinical information.
- Liaison between acute treating team and employer.
- Coordinate medical documents between MSP and employer.
- Assist with discharge planning sub-acute unit / home discharge.

In sub
- acute hospital:

- For each case, involvement in the: initial planning meeting (IPM), family meeting and discharge meetings sub-acute service provider
- Evaluate rehabilitation treatment, assistive device requests and authorize for medical invoice payments.
- Interpret rehabilitation plans and report appropriately.
- Plan and coordinate discharge plan with RMA/ Employer and MDT
- Coordinate transitioning to Vocational Rehabilitation/ re-skilling programs.
- Coordinate social reintegration: caregiver training/ home adaptation/ equipment authorization.

**Vocational Rehabilitation Pillar Tasks**

***Return-to-Work Program:

- Coordinate pre-discharge family meeting with employee, employer, caregiver, and healthcare providers.
- Approve/ authorise out-patient therapy for RTW support.
- Coordinate Functional Capacity Evaluation (FCE) for work readiness assessment, workplace evaluation and adaptations.
- Monitor post
- RTW and reporting.

Job-Reskilling or Job Incubation Program:

- Perform 'Interest Interview' with employee to identify preferred/ suitable skills/jobs.
- Engagement with re-skilling providers, oversee reskilling/job program success.
- Authorise therapy for re-skilling support.

Bursary Program:
**Social Re-integration Pillar Tasks**
- Coordinate psychosocial support with relevant MSPs for intervention as
- Coordinate all activities related to “independent living”: home adaptation, return to adaptive sport/ recreational tasks. Assess adaptive equipment and authorize. Link employee to relevant recreational organizations. Coordinate return to driving: engage relevant service providers/ agencies.

Home adaptations/ Care Facility admission
- Coordinate Social Worker/OT/PT for home evaluation and report
- in SA and SADC.
- Coordinate home adaptation process: finalization of claim (internal RMA liaison), coordinate funding of construction for recommended adaptations, liaison with employer. Track and report home adaptation success.
- Assess suitability for long-term placement, where worker is severely impaired/ no caregiver. Coordinate placement options.

**Reporting Tasks**

Internal
- Daily record keeping on the tracking platform.
- Tracking and document all interventions under the 3 pillars.
- Provide monthly progress reports to rehab manager.
- Monthly reports, statistics/ VR process
- Interdependent team: PMP, CCA, HUM, Welkom Rehab

External
- Employer: rehab report with individual case management plan, interpretation, and relay RTW possibility.
- MSP: authorization/ repudiation of rehab treatment/ equipment.

**Service Provider**:

- Re-skilling SP, NGOs

**General rehabilitation case management outputs**
- To re-assess the rehabilitation prognosis to sustainable return to work by looking at the medical prognosis, occupation as well as the claimants’ / pensioner’s response to treatment of possible cases referred to the case manager.
- To motivate where applicable for claimant’s return to work.
- To ensure that a quotation is obtained for claimants’ / pensioners’ specific rehabilitation programme and approval is requested via management.
- To ensure that upon approval the case is referred to the relevant rehabilitation specialist (which usually includes an occupational therapist or other health professionals such as physiotherapist or psychologist, and specialists).
- To ensure that the case management programme / plan is discussed with the claimant / pensioner, employer, and family.
- To monitor the rehabilitation progress closely through regular follows ups with the relevant independent therapist and the claimant / pensioner.
- To monitor complex claims that may become long-term claims if no rehabilitation intervention is received.
- To ensure early intervention and proactive case management of these cases by reviewing these claims and keeping in touch with claimants / pensioners and health professionals involved with treatment.
- Assist with the review of independent occupational therapist reports with specific reference to the matching of functional impairment with the job requirements of nominated o

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