What are the responsibilities and job description for the Nurse Program Case Manager position at Adult Community Educational Services, Inc (ACES)?
Overview
Join our dynamic healthcare team as a Nurse Program Case Manager, where you will play a vital role in coordinating inpatient care for adult clients who are survivors of traumatic brain injury/neurological impairment, to address the physical and behavioral rehabilitation needs of individual.
Responsibilities
- Coordinating with physicians, neuropsychologists, nurses, skilled therapists, behavioral analysts and other members of the clinical team, to ensure clients receive appropriate and efficacious care.
- Responsible for securing continued stay authorization by documenting medical necessity through the utilization review process.
- Maintaining a high degree of communication with clients, guardians, family members, and funding sources.
- Responsible for writing and proofing monthly client clinical service reports within required timeframes.
- Author appeal letters for submission with supporting documentation to insurance entities to reverse inappropriate denials of continued care.
- Ensuring all client/family questions and concerns are addressed and resolved in a timely manner.
Qualifications
- BSN or ADN with 2-3 years' experience in a medical setting.
- Current license to practice Nursing in Florida.
- Previous rehabilitation management and insurance experience is desirable.
- Excellent interpersonal oral and written communication and leadership are required.
- Knowledge of HIPAA regulations and medical records management to ensure confidentiality and compliance.
Job Types: Full-time, Permanent
Pay: $60,000.00 - $80,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
License/Certification:
- License to practice Nursing (Required)
Work Location: In person
Salary : $60,000 - $80,000