Case Manager - Skyline Healthcare Center-San Jose

SUMMARY

Coordinates and monitors the assessment, treatment planning process and follow up for each resident / patient to maximize reimbursement.  Serves as an advocate for reimbursement of health benefits.  Typically located in facilities with high Medicare and managed care census.

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

·         May participate in patient pre-placement planning. Conducts orientation and periodic assessments of individual residents’ needs.

·         Assists patients and families in advocating for reimbursement benefits.

·         Provides periodic assessments and summaries to insurers for continued authorization of care.

·         Coordinates the oversight of delivery of services based on intent of stay and prior level of function.  May include facilitation of patient review meetings and / or chart reviews.

·         Completes required forms and documents in accordance with company policy and state and/or federal regulations.

ENTRY QUALIFICATIONS

·         Graduate of an accredited School of Nursing.

·         Valid State registration as an LPN, LVN, or RN.

*    Current Social Work License in the State of California

Rate Negotiable based on experience.