Manager, Case Management en Generations Healthcare Network

Description

Manager, Case Management - Generations Healthcare Network, Lincolnwood, IL

Generations Healthcare Network, a Consortium of Skilled Nursing Facilities, seeks an Experienced Case Manager for its Four Skilled Nursing Facilities in Northern Illinois and Northeast Indiana.

The Manager, Case Management, is responsible for overseeing and coordinating the clinical and administrative aspects of patient care in a post-acute Skilled Nursing Facility (SNF) setting. The Case Manager serves as a liaison between the facilities, interdisciplinary teams, and payor sources in an effort to optimize outcomes, reimbursement, and regulatory compliance, while also supporting facility leadership.

50% travel between facilities is required.

We offer you a Salary between $85k and $110k, and you are Eligible for Company Benefits, including Choice of Health Care Plans, 401k w/Company Match, Dental, Vision and Life Insurance, Health Savings Account, and Much More!

Apply Today!

Qualifications of the Manager, Case Management:

• RN License, Illinois
• 2-3 years’ clinical nursing experience, with at least 1 year of case management and discharge planning. SNF and/or post-acute setting highly preferred
• Knowledge of Medicare, Medicaid (HFS), MCOs and commercial insurance processes, including prior authorizations, appeals, contract compliance and services agreements
• Familiarity with post-acute levels of care and transitions
• Understanding of payor contract structure
• Supervisory level experience with utilization review, reimbursement, and case management preferred
• Proficiency with electronic medical records and payor portals
• Excellent written and verbal communication skills; ability to interact with physicians and payers as well as residents and their families

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Requirements

Duties of the Manager, Case Management:

• Assessment of residents’ level of care throughout stay through utilization review
• Initiate and manage prior authorization requests with Medicare Advantage, MCOs and commercial payors
• Respond to denials, initiate appeals, track resolutions
• Ensure compliance and accurate billing in terms of payor contracts
• Participate directly with (re)negotiation of services agreements with various contracting entities
• Serve as primary point of contact with health plan representatives
• Regular travel to facilities required to provide departmental oversight and ensure payor engagement
• Provide education to staff, residents and families regarding insurance, discharge and care options
• Audit medical records to ensure thorough and accurate documentation
• Track patient progress against goals

Generations Healthcare Network is one of the industry’s leading consulting firms and premier providers of skilled nursing and rehabilitation services. Generations Healthcare Network is a newly minted brand to advance a generations long and successful tradition deeply rooted in the firm belief of providing quality healthcare services in warm, inviting, safe and amenities-filled facility environments.www.generationshealthcarenetwork.com

                                     ~ Our Family Caring for Your Family for Generations to Come ~