Assistant Case Manager

Job Description

Job Description

Assistant Case Manager

Job Summary:

We are seeking an experienced and detail-oriented Assistant Case Manager to join our team at AdviniaCare Newport. As a valued member of our team, you will assist the Case Manager in coordinating care for our skilled nursing and rehabilitation residents.

Responsibilities:

• Schedule and attend resident care plan meetings and send out invitations to family members

• Schedule and attend teleconference meetings with family members of skilled residents, if requested

• Follow up with interdisciplinary team members on non-completed sections of evaluations and forms required for insurance updates

• Retrieve and fax or upload to managed care portal medical records to managed care companies for utilization review purposes

• Track and schedule all certifications and recertification needed for skilled care

• Coordinate with Social Services to issue Medicare Advantage denial letters

• Retrieve and upload medical records to QIO website for any requested appeals

• Assist with compiling medical records and preparing for submission with subsequent level appeals to QIC, ALJ, etc.

• Track and submit all managed care documentation on review dates

• Monitor daily any change in resident status that would impact skilled level of care or discharge and assure managed care company is notified of changes in next review

• Update weekly UR board and attend weekly UR meeting

• Consult with Regional RN Case Manager as needed

• Assist with compiling medical records or other documentation as requested by Curis ADR department

• Scan and upload to PCC all Certs, NOMNCs and SNF ABNs

Qualifications:

• Certified nursing assistant or certified Medication tech

• At least 1 year experience in long term care

• Experienced with electronic medical records such as PCC

• Basic knowledge of Microsoft Word and Excel

Proficient with email and downloading/uploading documents