What are the responsibilities and job description for the Case Manager Specialist position at Corona Post Acute?
Are you a person who believes in providing great care? Do you believe in having a positive impact on other people's lives? Are you a team-player, quick-thinker, and ready to be a part of an organization that supports your growth?
WHAT WE'RE ABOUT
We believe care goes beyond a medical chart. With kindness and integrity as our guide, we strive for excellence in every interaction.
Requirements:
You care.
Case Manager Perks:
- Generous Bonuses
- Growth Opportunities
- Health Benefits
POSITION SUMMARY
This is a non-licensed nurse position. In coordination with Central Admissions and the Director of Case Management, this position will be responsible for requesting prior authorization on admissions to skilled needs, as well as for long-term residents that may need skilled services.
DUTIES AND RESPONSIBILITIES
- Meets and greets new admissions or readmissions.
- Conducts facility tours
- Ensures the admitting room is clean and ready for admissions.
- Point person for residents' needs
- Assists Central Admissions in requesting prior skilled authorization prior to admissions.
- Attends daily stand-up and stand-down meetings. Updates team regarding patients' skilled authorization requests or discharge plans and morning patients' round concerns.
- Requests Long Term Care (LTC) authorizations and skilled authorizations for LTC residents who need skilled services.
- Sends clinical notes to the health plans in coordination with the Director of Case Management, to request extended skilled authorizations.
- Update custodial authorizations to Point Click Care
- Submit/Request Custodial Re-Authorizations
- Requests for prior authorizations and LOA
- Inputting admissions into Point Click Care
- Provide copy of inquires to nursing
- Updates daily HMO skilled spreadsheets.
- Updates Accounts Receivables (AR) spreadsheets.
KNOWLEDGE, SKILLS, ABILITIES & QUALIFICATIONS
- Previous experience in healthcare field preferred
- Experience in working with Health Plans in obtaining authorizations - preferred but not required
- High school diploma or equivalent required
- Must be able to read, write and speak the English language sufficiently and comprehensibly enough to perform the essential functions of the job
- Sufficient computer skills including proficiency in Microsoft Office, Outlook, and /or Internet to perform required duties
- Knowledge of standard office practices
- Ability to understand and follow applicable regulations, policies and procedures fully and consistently
- Good grammatical, punctuation and spelling skills
- Must have strong detail orientation and high accuracy level .
