Demo

Remote Case Manager (Managed Care)

ProMotion Healthcare Services
North Wales, PA Remote Full Time
POSTED ON 1/28/2025
AVAILABLE BEFORE 2/26/2025
Remote Case Manager (Managed Care) - Long-Term Care | The LiveWell Centers

The LiveWell Centers is seeking a dedicated Remote Case Manager with expertise in Managed Care and a passion for long-term care. As part of our mission-driven team, you’ll play a pivotal role in coordinating patient care plans, optimizing outcomes, and ensuring smooth transitions of care—all while working from the comfort of your home.

Key Responsibilities:

  • Managed Care Coordination: Use comprehensive knowledge of managed care contracts to negotiate care levels with payors.
  • Long-Term Care Focus: Manage care plans and transitions for long-term care patients, ensuring compliance with payor requirements.
  • Utilization Management: Compile, review, and submit clinical documentation for insurance authorizations, continued stay reviews, and appeals.
  • Interdisciplinary Collaboration: Act as a liaison between patients, healthcare teams, and payors to streamline communication and care delivery.
  • Stakeholder Education: Train internal teams and educate families on managed care processes, insurance coverage, and benefits.
  • Claims and Billing Support: Address billing issues, assist with claims appeals, and contribute to accounts receivable processes.
  • Performance Reporting: Analyze monthly P&L reports, identify trends, and recommend improvements to enhance patient outcomes and operational efficiency.


Qualifications:

  • Education: Bachelor’s degree in healthcare or related field preferred; licensure or certification in health or human services is a plus.
  • Experience: At least 4 years in healthcare, including 2 years in Case Management. Experience in long-term care, managed care, and insurance processes is highly preferred.
  • Skills: Strong leadership, problem-solving, and organizational skills. Proficiency in Microsoft Office (Word, Excel, PowerPoint) required.


Benefits:

At The LiveWell Centers, we believe in supporting our employees with a comprehensive benefits package, including:

  • Health Insurance: Comprehensive medical coverage.
  • Dental and Vision Insurance: Affordable dental and vision plans.
  • Paid Time Off (PTO): Generous PTO to support work-life balance.
  • Disability Insurance: Short-term and long-term disability coverage.
  • Retirement Plan: Competitive retirement savings options.
  • Wellness Resources: Access to wellness programs and resources.


Why Join The LiveWell Centers?

  • Remote Flexibility: Fully remote position, offering work-life balance and flexibility.
  • Competitive Salary: $75,000 to $80,000 per year.
  • Long-Term Care Expertise: Be part of a mission-driven team dedicated to enhancing care for long-term care patients.
  • Professional Impact: Collaborate with interdisciplinary teams to drive meaningful patient outcomes.


Apply Today!

If you’re passionate about long-term care and managed care and thrive in a collaborative, patient-focused environment, we’d love to hear from you. Join The LiveWell Centers and make a difference in the lives of those we serve!

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Salary : $75,000 - $80,000

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