Rehabilitation Care Coordinator

Posted Date 4 weeks ago(11/1/2022 11:57 AM)
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Serves as clinical care coordinator, providing oversight of Beechwood NeuroRehab's individual’s treatment programs, and providing liaison between staff, families, and funding sources.  Acts as the Chairperson of all transdisciplinary teams and ensures that all regulations/standards pertaining to the individual's program are in compliance with all regulations/standards governing Woods.  Responsible for ensuring that the transdisciplinary team process produces a positive and individualized outcomes.  Responsible for maintaining the individual’s record and providing clinical social services to persons served and their families.


  • Chairs Internal Team Conferences, Program Review Conferences and Rehab Service Planning (RSP) meetings and oversees the entire treatment planning process.  
  • Assures all rehab services are provided according to treatment plan.
  • Assures that program services and goals relate to the overall expected functional outcomes desired by each individual/family.
  • Coordinates RSP and progress reviews and assures their completeness, timeliness, compliance with regulations, and transmittal to families and funding agencies.
  • Insures Personal Care Home Assessments and Support Plans are done according to 2600 regulations, and are appropriate to the individual's needs.
  • Provides for proper maintenance and dissemination of the individual’s records assuring rights to confidentiality.
  • Provides ongoing information and support to individuals, families, and funders. Understands the expectations and concerns of the families/funders. Communicates this information to team members. Immediately notifies upper management regarding serious family/funder concerns for the safety and welfare of individuals, of any serious family/funder dissatisfaction with program, and of any indication of potential discharges.
  • Provides assistance to families and individuals with Social Security issues, waiver eligibility, insurance billing issues and other legal/financial/benefits issues as needed. Obtains funding approval for all Beechwood NeuroRehab provided services. Understands each individual’s funding/insurance arrangements and how they impact on services, length of stay, etc. so that individuals’ resources are used effectively.
  • Assists individuals and families with discharge planning. Coordinates discharges with new care providers
  • Performs all other duties as assigned.


  • Bachelor’s degree from an accredited college or university in Social Work or related Human Service Field.  
  • Two years’ experience in social work/rehabilitation setting serving people with cognitive and physical impairments preferred.
  • Knowledge of acquired brain injury and neurological disorders, knowledge of social service and rehabilitation systems preferred             
  • Experience chairing meetings and working in social work/ case-management strongly preferred.
  • Must have strong written and verbal communication, organizational, time management and multi-tasking skills.
  • Valid driver’s license and vehicle required.
  • Must be able to communicate verbally in English. Must be at least 21 years of age


  •  Demonstrates thorough understanding of the impact acquired brain injury and other neurological conditions has on individuals and their families and how NeuroRehab services can bring about change and improvement in one’s ability to more fully participate in daily life and integrate more fully into their community of choice.
  • Demonstrates a thorough understanding of each individual’s brain injury rehabilitation service plan as it relates to the overall functional outcome of the person served from admission to post discharge follow up. Be able to effectively communicate this information to individuals, families, funders and other stakeholders as authorized.
  • Demonstrates an understanding of the expectations and concerns of the persons with acquired brain injury and their family/funders. Is able to effectively communicate this information to team members.  Recognizes serious dissatisfaction of stake holders and alerts Beechwood NeuroRehab Administration.  Demonstrates the ability to follow up until concerns are resolved.
  • Demonstrates thorough understanding of funding sources and insurance plans typical to persons served at Beechwood NeuroRehab and how the type of funding affects service provision, length of stay, reimbursement for Beechwood NeuroRehab services, and reimbursement for medical and dental care, DME, and pharmacy. Have thorough understanding of Social Security, Access and Medicaid Waiver eligibility in order to be able to assist as needed individuals and their families in obtaining and maintaining eligibility. 
  • Demonstrates knowledge of community resources of benefit to persons served and their families, make appropriate referrals and follow up so that needs are met. (Transportation services, local support groups, legal aid, advocacy, housing etc)
  • Demonstrates thorough understanding of required Beechwood NeuroRehab documentation procedures. Demonstrate adherence to confidentiality regulations with regard to the disclosure of protected information.
  • Demonstrates respect for diversity and recognize the unique needs and values of individuals.
  • Demonstrates the ability to collaborate with other Beechwood NeuroRehab team members, showing respect for the contributions of others.
  • Demonstrates effective communication skills both written and verbal, specifically the ability to write clearly, to understand written information, to speak effectively, to listen attentively and ensure information being communicated is understood. Demonstrates calm, professional manner even during stressful situations.
  • Demonstrates a high degree of organizational skill and the ability to effectively prioritize multiple demands. Maintains routines and systems that insure task completion in a timely manner.


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