Case Manager – Skilled Nursing Facility

Description

ProMedica Senior Care provides a range of services, including skilled nursing care, assisted living, post-acute medical and rehabilitation care, hospice care, home health care and rehabilitation therapy.

Job Summary

Responsible for facilitating interdisciplinary plans and assuring progress reports are completed and provided to payor as required; Also serves as liaison between patient, physician, care team members, payor, and the discharge planner by coordinating, monitoring, and communicating patient’s progress and cost evaluation and assisting with coordination to the next level of care.

In return for your expertise, you’ll enjoy excellent training and unlimited opportunities to learn and grow. Be a part of the team leading the nation in healthcare.

Case Manager Responsibilities

• Negotiates appropriate level of care within contract terms with the payor case manager; Utilizes “Out of Contract Pricing Worksheet” for non-contracted arrangements.
• Communicates information to care team and coordinates patient’s smooth transition to the next level of care.
• Obtains accurate information from physicians, patient, and payor source regarding the expected discharge plan and communicates this information to the interdisciplinary team
• Develops referrals from hospitals’ social service and discharge planning departments, physicians, case managers, insurance companies and other referral sources
• Participates in Marketing Action Plan and Key Account Meetings, and assumes Key Account Management responsibilities as directed by their supervisor.
• Visits hospital social workers, physicians, hospital discharge planners and administrators, attorneys, support organizations (i.e., oncology, stroke, head injury, etc.) , civic/professional organizations, etc. to understand the need for program services and to communicate services offered which meet these needs to obtain referrals of patients.

Location

692 – ProMedica Skilled Nursing and Rehabilitation – Brightwood, Maryland

Educational Requirements

College degree in the health & human service field required. Current, active, and unrestricted licensure or certification in a health or human services discipline preferred.

Position Requirements

Minimum two (2) years experience in medial case management. Comprehensive knowledge of workers’ compensation, insurance, and managed care, required. Ability to negotiate coverage and provide complete and timely case mgmt reports, required. Prior experience with an insurance company, private case mgmt. Company, or HMO, preferred. Familiarity with long- term care and/or sub acute care, useful. Strong oral and written communication skills, required.