OverviewAre you a RN, LPN, or Therapist that is passionate about case management? As the Director of Care Coordination you will coordinate and lead center's overall case management to include effective and efficient utilization of clinical resources to achieve desired results in desired timeframe.
If you wish to make a difference in the lives of our patients and residents,
APPLY NOW!Full Time Benefits include: - Medical/Dental/Vision
- Excellent 401k plan
- Tuition Reimbursement
- Vacation, Holiday, and Sick Time
- Long and Short Term Disability
- Employee Assistance Program
- Life Insurance
- Referral Bonuses
- DiversICARE - employee hardship fund
- Pay advancement program - OnShift Wallet
#ND123
Responsibilities- Facilitates daily care coordination meetings to ensure care resources are aligned with benefits and patient needs
- Participates and facilitates Engage/72 HR Admission meeting. Ensures coordination as part of the care management system
- Responsible for the coordination of the restorative nursing program including integration of the activity department
- Ensures timely communication with the patient/family regarding changes in condition and discharge planning
- Responsible for the ongoing communication to all insurance case managers
- Manages all initial reviews, interim reviews and discharge reviews (Managed Care authorizations/reauthorizations).
- Collaborates with clinical team in the development and execution of care plan
- Ensures timely facilitation of patient care rounds/conferences to review treatment plan and identify discharge and post discharge needs
- Ensures utilization of company tools/resources related to care management - e.g. Dart Chart/Managed Care Log
- Coordinates discharge planning and post-discharge communication - home health/DME, etc.
- Determines need for non-coverage notification and is responsible for issuance of the beneficiary notices as well as communication with patients/families/payers
- Monitors Quality Measures along with other members of care coordination team
- Serves as a skilled care documentation specialist ensuring that Medicare and Managed care regulatory guidelines are completed accurately and timely (i.e. certifications, denial letters, skilled documentation, coverage criteria, etc.)
- Reviews Additional Documentation Requests (ADRs) with Health Information Management Coordinator (HIMC) to ensure all documents are available and meet the request
Qualifications- Degree in nursing, therapy or other related clinical field (i.e. social services), must hold a current license in respective field.
- Knowledge of healthcare reimbursement, utilization management, and discharge planning.
- Experience providing strategic leadership, managing teams and leading projects required.
- Ability to formulate and implement short and long term strategic plans
- Strong verbal, written and interpersonal skills.
- Must have proven ability to lead a team to achieve desired outcomes of team
- Strong communication and organizational skills required
- Must have knowledge of PDPM requirements of insurers
- Must have understanding of regulatory requirements
- Previous case management experience preferred
