Offer summary

Qualifications:

Valid state LPN license preferred; PTA and OTA encouraged to apply., Knowledge of Managed Care and nursing needs of the aged and chronically ill., Experience in skilled nursing facilities and clinical reimbursement is desirable., Excellent communication skills and proficiency in Microsoft Office 365..

Key responsabilities:

Advocate for residents by producing case documentation.

Review clinical documentation for medical necessity and level of care appropriateness.

Collaborate with the treatment team to create patient-centered cases for skilled nursing coverage.

Develop relationships with insurance representatives and facilitate managed care team meetings.

Job description

A Great Place to Work

As a Certified Great Place to Work, we think that you are going to love it here. Your work will be meaningful to you. You will make a genuine difference in the lives of our aging guests and the families that love them. You will enjoy lasting bonds with the families you meet and with the teams you work on. And if you desire, you will experience real career growth where your expertise and dedication is valued and appreciated. We invite you to join our team!

Fully remote

Monday–Friday schedule, but not a traditional 9–5 job

PCC and Health.NET experience preffered

What You'll Do:

As a Regional Case Manager, you will play a vital role in advocating for short-term skilled nursing patients by reviewing the medical record and collaborating with the interdisciplinary team in creating a rationale for medical necessity and submitting it to their health plan for continued stay approval. You will be an active member of the team, where you will help to optimize patient outcomes and reduce readmissions.

Key Responsibilities:

Advocate for our residents by producing case documentation
Review clinical documentation for medical necessity and level of care appropriateness
Collaborate with treatment team to create a patient-centered case of medical necessity and rationale for skilled nursing coverage
Provide rationale and supporting documentation regarding continuum of care to promote best practice outcomes and patient-centered discharge planning
Develop and maintain relationships with insurance representatives and facilitate managed care team meetings

If you are a compassionate and organized healthcare professional with a passion for ensuring positive patient outcomes, consider joining our team as a Regional Case Manager! Make a real difference in people's lives in an organization where your expertise and dedication are valued and appreciated.

What We Offer

Competitive compensation and benefits package
Comprehensive training and mentorship
Opportunities for professional growth and development
Supportive and collaborative work environment
The chance to make a meaningful difference in the lives of our residents

Rate of Pay: USD $75,000.00 - USD $85,000.00 /Yr. -:

What You'll Bring:

Qualifications of a Regional Case Manager include:

Valid state LPN license preferred PTA and OTA encouraged to apply
Knowledge and understanding of Managed Care Interest in the nursing needs of the aged and the chronically ill with the ability to work with both
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable
Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
Excellent communication and interpersonal abilities
Must be proficient with Microsoft Office 365 Ability to work effectively in a multidisciplinary team environment

We Hire for Heart!

National Health Care Associates (National) is proud to be a family-run organization since 1984. Like family, each of National’s centers are unique but share common values: Kindness, Service, Compassion and Excellence. Today, our centers include more than 30 premier providers of short-term rehabilitation, skilled nursing, and post-hospital care including several named “Best Of” by US News & World Report. When you join the team at a National center, you join a team that provides life-changing care to thousands of patients, residents, and families in a Great Place to Work Certified environment.

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