Case Manager - Skilled Nursing Facility
HCR ManorCare provides a range of services, including skilled nursing care, assisted living, post-acute medical and rehabilitation care, hospice care, home health care and rehabilitation therapy. Job Summary Responsible for facilitating interdisciplinary plans and assuring progress reports are completed and provided to payor as required; Also serves as liaison between patient, physician, care team members, payor, and the discharge planner by coordinating, monitoring, and communicating patients progress and cost evaluation and assisting with coordination to the next level of care. In return for your expertise, youll enjoy excellent training, industry-leading benefits and unlimited opportunities to learn and grow. Be a part of the team leading the nation in healthcare. Case Manager Responsibilities Negotiates appropriate level of care within contract terms with the payor case manager; Utilizes Out of Contract Pricing Worksheet for non-contracted arrangements.Communicates information to care team and coordinates patient's smooth transition to the next level of care.Obtains accurate information from physicians, patient, and payor source regarding the expected discharge plan and communicates this information to the interdisciplinary teamDevelops referrals from hospitals' social service and discharge planning departments, physicians, case managers, insurance companies and other referral sourcesParticipates in Marketing Action Plan and Key Account Meetings, and assumes Key Account Management responsibilities as directed by their supervisor.Visits hospital social workers, physicians, hospital discharge planners and administrators, attorneys, support organizations (ie, oncology, stroke, head injury, etc.) , civic/professional organizations, etc. to understand the need for program services and to communicate services offered which meet these needs to obtain referrals of patients 539 - ManorCare Health Services - Fairfax, Virginia Minimum two years medical, clinical, concurrent review or pre-certification case management experience preferred. Comprehensive knowledge of workers' compensation, insurance, and managed care required. Ability to negotiate coverage and provide complete and timely case management reports required. Prior experience with an insurance company, private case management company or HMO preferred. Familiarity with long- term care and/or sub-acute care useful. Strong oral, written, and organizational communication skills required.