Posted in General Business 30+ days ago.
Type: Full-Time
Location: Brentwood, Tennessee
The Regional Case Manager position assists with referral management, coordination of provider approvals, and provides comprehensive clinical and rehabilitation updates with managed care and BPCI/Bundled payment payer groups. Regional Case Managers ensure appropriate level of reimbursement for patient specific care needs and work collaboratively with interdisciplinary team and providers.Leads the case management process from admission through patients next lower level of care.Fosters and develops partnerships with insurance case managers to ensure all patient updates are delivered timely.Reviews, analyzes, and facilitates authorizations of referral information in coordination with the sales & marketing team, business office representative, interdisciplinary team, Director of Clinical Services, Health Care Administrator, legal representative, and claims/insurance agency as indicated.Negotiates rates for improved reimbursement if necessary to capture additional care needs and ancillary services to support patients care needs in a timely manner.Communicates and provides documentation periodically to insurance providers for approval of coverage during skilled stay.Knowledge of all managed care contracts that is under management.Partners with community IDT to collaborate with health care specialists to identify necessary ancillary services and support.Demonstrates compliance with facility and departmental safety and security policies and practices.Assists with educating hospital team members and physicians on case manager role at the community.Attends Weekly Medicare/IDT meeting to ensure patient care needs, appropriate length of stay, and payer expectations are coordinated.Coordinates the delivery of the Notice of Non-Coverage to resident and/ or legal representative in a timely matter.Provides excellent written and verbal communication to patients/families, inpatient case managers, managed care organizations, providers, and other skilled nursing team members.This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.Seeking Regional Case Manager for SNF PortfolioRemote OpportunityVoted by Newsweek in 2024 as one of America's Greatest Workplaces for DiversityMake Lives Better Including Your Own.If you want to work in an environment where you can become your best possible self, join us! Youll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness.Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Additional benefits offered include, but are not limited to:Tuition ReimbursementPet InsuranceAdoption Reimbursement BenefitsVariety of Associate DiscountsVeterans, transitioning active duty military personnel, and military spouses are encouraged to apply.To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year.
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