• Regional Case Manager - Ohio Valley - Atrium Centers

    Job Locations US-OH-Columbus
    ID
    2018-4201
    Facility Name
    Atrium Centers Inc.
    Category
    Non-Nursing
    Type
    Regular Full-Time
  • Overview

    Atrium Centers is a leading provider of short-term post-acute rehabilitation and long-term nursing care. We currently operate skilled nursing centers in Ohio, Michigan, Kentucky, and Wisconsin.

    Our reputation is defined by our employees, the caring and skilled staff members who are the foundation of our award-winning communities.

    We are committed to treating each individual with respect and dignity in a homelike environment. Our professional and caring staff provides exceptional services tailored to the individual needs of residents and meeting the highest industry standards.

    Responsibilities

    Atrium Centers is currently hiring a Regional Case Manager to oversee multiple facilities in Ohio and Kentucky. This position will work remotely, with occasional travel to facilities and the Corporate office in Columbus, OH.

     

    ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

    • Responsible for accurate assessment of referrals thru medical record review prior to admission to skilled nursing facilities including clinical needs, discharge considerations, payment sources, and patient/family expectations of admission.
    • Negotiate per diem/level within contract limitations.
    • Responsible for precertification and recertification of skilled patients.
    • Coordinate assessment with entire medical team for objectives, goals and plan for achievement.
    • Communicate with payer case management ongoing to ensure clinical information conveys skilled need utilizing Interqual or MCG (formally Milliman) criteria and following Medicare guidelines.
    • Interact and coordinate with rehab team, MD, SW and nursing the necessary information required for a weekly report and discharge planning.
    • Performs:
      • Critical thinking and problem solving.
      • Flexible and adaptive to a changing environment.
      • Able to work in a team atmosphere as well as autonomously.
      • Adept with technology, clinical and prioritization problem solving skills.
      • Support change and innovation.
      • Passion for making a difference, positively impacting the lives of those we serve and delivering quality results.

    Qualifications

    EDUCATION and/or EXPERIENCE

    Bachelor’s Degree in healthcare related field. Licensed professional nurse may be considered. Minimum of two (2) years of utilization review/case management or home health experience or social work experience. Minimum of one (1) year experience in discharge planning from a hospital is preferred. Maintain current professional licensure in nursing or professional field of certification.

    Long Term Care Experience is required.

     

    QUALIFICATIONS

    • Thorough knowledge of insurance and Medicare requirements for skilled nursing facility approval.
    • Strong customer service and communication skills.
    • Self-motivated and organized; able to function and achieve goals independently
    • Familiarity of working in a multi-facility environment.PERFORMANCE MEASUREMENTS
    •  
    • Documentation of insurance communication maintained to ensure payment.
    • Appropriate levels of care based on clinical needs.
    • Expected patient outcomes achieved based on defined levels of care.
    • Insurance Health Management Team satisfaction.  

    CERTIFICATES, LICENSES, REGISTRATIONS  Social Work License or Registered Nurse (Licensed Professional Nurse may be considered).

     

     

     

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