What are the responsibilities and job description for the Case Manager Managed Care position at Progressive Quality Care?
About our Company:
Our company is a family-owned business founded by Rose and Hugo Dancziger. We got our start with the 1960's purchase of the Little Flower Nursing Home in Parma, Ohio. They firmly believed in making every resident feel the warmth and caring of home as each became an integral part member of their new family. Rose and Hugo left a legacy for their children and grandchildren to emulate - to bring a sense of family and love into the lives of those in their care, to give each resident the respect and caring reserved for family, and to provide them with a home. We continue to live by their example. We are committed to providing an excellent level of physical, medical, emotional, and spiritual support. We believe in Life Enrichment and embracing the good during these more difficult times in our residents' lives. We are constantly changing and adapting with the ever-growing industry of long-term care, and our state-of-the-art, hotel-like facilities are the pinnacle of what long-term care should look like. At the heart of it all, we still operate like the family-owned company that we are, and value each other as much as we do our residents as we work together to be at the forefront of the industry with our ever-growing portfolio of long-term care communities.
Job Summary: We are seeking a dedicated and experienced Case Manager to join our team. The ideal candidate will oversee the case management for our managed care residents, ensuring the delivery of high-quality patient care and compliance with healthcare regulations and managed care protocols.
Key Responsibilities:
- Assisting with coordination of patient care, ensuring they meet the needs of patients and managed care companies
- Collaborate with healthcare providers, insurance companies, and other stakeholders.
- Monitor and evaluate patient outcomes, making adjustments as necessary.
- Ensure compliance with all federal, state, and local regulations.
- Provide training and development opportunities for staff.
- Monitor reimbursement and work closely with accounts receivable department
- Oversee concurrent reviews and precerts
Qualifications:
- Current RN, LPN
- Minimum of 3 years of experience in case management, preferably in a skilled nursing facility.
- Strong leadership and team management skills.
- Excellent communication and interpersonal skills.
- Knowledge of healthcare regulations and compliance requirements.
- Ability to work effectively in a fast-paced environment.
- Self starter and proactive communication skills
Benefits:
- Competitive salary and benefits package.
- Opportunities for professional development and career advancement.
- Supportive and collaborative work environment.