What are the responsibilities and job description for the Regional Case Manager (REMOTE) position at Wethersfield Corporate Office?
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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!
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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.
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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
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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.
Salary : $75,000 - $85,000
