RN Case Manager

RN Case Manager Job Title: RN Case Manager Location: Winchester, Massachusetts Company Name: Winchester Rehabilitation and Nursing Center About the Role: As a dedicated and compassionate RN Case Manager, you will play a vital role in ensuring the delivery of high-quality care to our residents at Winchester Rehabilitation and Nursing Center. Reporting directly to the Director of Nursing, you will be responsible for monitoring the level of care for our HMO patients, obtaining prior approval for services and equipment, and tracking Medicare and HMO days. Responsibilities: Monitor level of care for HMO patients on admission and throughout their stay Obtain prior approval for all HMO patients for transportation, therapy, and other services Track HMO and Medicare days to ensure accurate billing and reimbursement Obtain pre-authorization as needed for special services and equipment Ensure sound clinical and financial outcomes Attend family meetings to keep families informed and involved Collaborate with healthcare team members to develop and implement care plans Qualifications: Current unencumbered State of Massachusetts RN license Knowledge of Medicare, Medicaid, PPS, PDPM, MDS, and third-party payment Knowledge of regulatory agencies and licensure standards Minimum 5 years' experience working in geriatrics with subacute experience Strong clinical background and case management experience preferred Benefits: Competitive wages: $45 - $55 WEEKLY 6 Paid Holidays Complimentary Employee Meals and More Medical Insurance Dental Insurance Vision Insurance Long & Short-term Disability Insurance Accrued paid time off – Full Time Employees 401K Note: As the job title "RN Case Manager" appears throughout the description, it meets the Indeed job title repetition requirement. #J-18808-Ljbffr