Central Case Manager - Beecan Health - CA

Are you a person who believes in providing great care? Do you believe in having a positive impact on other people's lives? Are you a team-player, quick-thinker, and ready to be a part of an organization that supports your growth?

WHAT WE'RE ABOUT

Plain and simple:

At Beecan Health, we believe that anyone can learn skills, but not everyone can learn heart. Join us in #becomingabeecan today!

Position Summary:

The Central Case Manager provides support to skilled nursing facilities by taking the lead in care coordination, authorization management, and assist with the discharge planned. This role reports directly to the Regional Case Manager. Although the role is based out of the Home Office, light travel is required to maintain weekly facility visits.

Responsibilities

• Confirm and review prior authorizations obtained by the admissions team, and verify level of care on authorizations are in line with contracted level definitions
• Confirm facility's contracted status or that the obtained LOA from the appropriate payer by the admissions team
• Manage all existing authorizations through concurrent review submissions.
• Identify exclusions as outlined in payer contracts, obtain authorizations when necessary, and communicate with business office to ensure appropriate billing
• Verify the discharge plan as documented by Social Services capture all discharge needs and make arrangements prior to discharge date; to include home health, DME, etc.
• Arrange transportation and appointment schedules for skilled managed care residents
• Attend daily/weekly/monthly meetings with facility-based department heads to support a robust process in the delivery of care and authorization management
• Monitor patient's progress toward established clinical goals, periodically reassess changes in health status
• Obtain new authorizations for managed care Part B services
• Maintain tracking log to support clear information and billing

Qualifications

• Current and valid nursing license in the state required (RN or LVN)
• Bachelor's degree in a work-related discipline/field from an accredited college or university is preferred but not required
• At least two (2) years of experience working as a Case Manager
• Working knowledge of Case Management and Managed Care as it relates to authorizations and financial risk
• Advanced organizational skills
• Proficiency in Microsoft Office product