POSITION SUMMARY

The of the LVN Case Manger position is to coordinate delivery of services to managed care and Medicare residents in accordance with current federal, state and local standards and regulations that govern the facility and in collaboration with the Administrator, Director of Marketing, and other facility staff.

The Case Manager monitors and documents the cost effectiveness of treatment provided, coordinates the admission and discharge process, serves as the resident/family advocate, and acts as liaison to insurance and medical management professionals.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Managing all types of insurance cases from admission through discharge
• Following up with residents’ post-discharge follow up
• Communicating by phone or in writing the resident’s status and changes in care plan to payer
• Documenting all payer interactions regarding resident progress and expected outcomes
• Maximizing benefits by coordination of cost effective care
• Meeting with facility interdisciplinary team to coordinate services and ensure total regimen of resident care is achieved
• Frequently speaking with business office and collaborating with other departments to ensure accurate census and payment of residents
• Daily review of medical records to confirm compliance with medical necessity
• Planning and organizing time and duties to efficiently maintain caseload
• Reporting any occupational exposures to blood, body fluids, or other hazardous materials to a supervisor immediately
• Protecting each residents file and data with confidentially per HIPAA standards
• Abiding with all facility policies and procedures including not disclosing user ID codes and passwords

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies these are the only duties you will be required to perform as directed by management. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

REQUIREMENTS

Education / Licensure

• Valid LVN license in good standing
• Valid CPR and BLS card

Qualifications / Experience

• Minimum of 1 year experience in case management in a skilled nursing facility
• Must have 5 or more years as a licensed nurse
• Excellent verbal and written skills
• Knowledge of Point Click Care helpful

• Per California state mandate, the COVID 19 vaccine is required for this position

INDEMP