Case Manager

2 days ago

Saint Petersburg, United States Westminster Communities of Florida Full time
Westminster Suncoast a beautiful active living retirement community located in St. Petersburg is currently seeking a FT Case Manager Liaison. LPN or RN license required. Westminster offers a generous compensation and benefit package, including company paid Life insurance, LTD insurance, Pension plan, Wellness Program and Fitness Center.

Do not wait to apply after reading this description a high application volume is expected for this opportunity.

Summary: Performance of clinical assessments for potential and current Westminster Services health center residents. Negotiation for residents who are clients of managed care organizations. Liaison for community relations, discharge planners, and Physicians. Support for all Marketing efforts. Maximize cost effectiveness across the entire continuum of care; improve customer satisfaction and enhance quality of care.

Essential Job Functions include but not limited to: Comply with all applicable rules, standards and guidelines related to employment with Westminster Services and its communities.

Works as community liaison for referrals from physician, hospitals, insurance based case manager, or marketing personnel on all potential sub-acute patients, ensures initial and on-going fiscal appropriateness of member admissions in conjunction with Business Office and Director of Nursing
Assists the community with tracking of authorization numbers of residents on Managed Medicaid and other Managed Care Instance plans.
Works with community staff to monitor and track resident's progress and communicate relevant information between resident, referrer, family, instance company, and treatment team, communicates with the interdisciplinary member care team.
Works with residents, families and other staff as needed to ensure that residents are evaluated for the appropriate level of care.
Assists with coordination, monitoring, and communication of resident's progress and costs.
Fosters positive relationships with insurance representatives and providers in in the local market.
Address quality measures issues for potential admissions and returning residents.
Complete Pre-Admission process in EHR for new admissions.

To learn more about our culture and what it is like to work at Westminster Communities of Florida, follow us on our social channels (Facebook and Instagram) at @WestminsterCareers.

EOE, DFWP, "We honor those who have served".

Experience
Required
1 year(s): Post acute rehabilitation.
2 year(s): Long term care and assisted living, including working knowledge of medicare and managed care and Managed Medicaid protocals.
Licenses & Certifications
Required
LPN
Preferred
RN

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