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Case Manager - Skilled Nursing Facility (PRN) in Pittsburgh

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Job Ref:  314361718
Employer:  Network
Company Name:  HCR ManorCare
Industry:  Sales
Job Type:  Full Time
State:  Pennsylvania
City:  Pittsburgh
Zip Code:  15201

HCR ManorCare provides a range of services, including skilled nursing care, assisted living, post-acute medical and rehabilitation care, hospice care, home health care and rehabilitation therapy.

Job Summary

Responsible for facilitating interdisciplinary plans and assuring progress reports are completed and provided to payor as required; Also serves as liaison between patient, physician, care team members, payor, and the discharge planner by coordinating, monitoring, and communicating patient's progress and cost evaluation and assisting with coordination to the next level of care.

In return for your expertise, you'll enjoy excellent training, industry-leading benefits and unlimited opportunities to learn and grow. Be a part of the team leading the nation in healthcare.

Case Manager Responsibilities

  • Negotiates appropriate level of care within contract terms with the payor case manager; Utilizes "Out of Contract Pricing Worksheet" for non-contracted arrangements.
  • Communicates information to care team and coordinates patient's smooth transition to the next level of care.
  • Obtains accurate information from physicians, patient, and payor source regarding the expected discharge plan and communicates this information to the interdisciplinary team
  • Develops referrals from hospitals' social service and discharge planning departments, physicians, case managers, insurance companies and other referral sources
  • Participates in Marketing Action Plan and Key Account Meetings, and assumes Key Account Management responsibilities as directed by their supervisor.
  • Visits hospital social workers, physicians, hospital discharge planners and administrators, attorneys, support organizations (i.e., oncology, stroke, head injury, etc.) , civic/professional organizations, etc. to understand the need for program services and to communicate services offered which meet these needs to obtain referrals of patients
482 - ManorCare Health Services - Greentree, Pittsburgh, Pennsylvania

Minimum three years clinical experience and two years medical case management experience preferred. Comprehensive knowledge of workers' compensation, insurance, and managed care preferred. Ability to negotiate coverage and provide complete and timely case management reports required. Prior experience with an insurance company, private case management company or HMO preferred. Familiarity with long- term care and/or sub-acute care useful. Strong oral and written communication skills required. RN/LPN-LVN/SW encouraged to apply.