Case Management Resource

2 weeks ago

Oxnard, California, United States Glenwood care Center Full time

Case Management Resource

Location: Remote with Required Onsite Support & Training

Employment Type: Full‑Time, Exempt

Department: Case Management / Managed Care

About the Role

The Case Management Resource plays a critical role in elevating case management performance across our skilled nursing facilities. This position provides remote operational oversight combined with regular onsite training, coaching, and workflow support. You will help ensure the highest standards of patient care, strengthen relationships with payer partners, optimize operational efficiency, and drive improved clinical outcomes and patient satisfaction across our managed care population.

Key Responsibilities

Case Management Operations & Performance

Ensure timely submission of authorizations, including prior authorizations, concurrent reviews, and re‑authorization requests.

  • · Monitor and maintain Managed Care performance scorecards.

  • · Support care managers with complex case escalations and payer communication.

  • · Promote best practices in case management workflows.Training, Coaching & Onsite Support

  • · Provide onsite training and oversight to skilled nursing facility care managers.

Payer, Clinical & Continuum Collaboration

  • · Strengthen relationships with health plans, ACOs, IPAs, hospitals, and ancillary providers.

  • · Communicate payer expectations and updates.

  • · Support clinical and operational partners to align capacity and throughput.

  • · Participate in transition calls and IDT meetings.

2 / 2Compliance, Documentation & Quality Assurance

  • · Ensure adherence to state, federal, CMS, and company standards.

  • · Evaluate documentation quality for accuracy and compliance.

  • · Assist with audits and managed care reviews.

  • · Maintain compliance with company policies, including Travel & Expense.

Qualifications

Required

  • · Active LVN, RN, or other clinical certification/degree.

  • · Experience with managed care populations.

  • · Ability to train, coach, and support facility care managers.

  • · Strong understanding of case management workflows.

  • · Proficiency in maintaining performance scorecards.

  • · Excellent communication and organizational skills.

  • · Ability to travel regularly.

Work Environment & Travel Requirements

This is a remote-first role but requires consistent onsite presence for reviews, training, and support.

All travel must comply with company policies.

Core Values

Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership.

Compensation & Benefits

Competitive compensation with comprehensive benefits.

  • · Coach staff on payer requirements and documentation quality.

  • · Develop training materials and workflow tools.

  • · Evaluate facility workflows and guide improvements.

Job Type: Full-time

Pay: $90, $120,000.00 per year

Benefits:

  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Work Location: Hybrid remote in Oxnard, CA 93030

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