Admissions Case Manager
TMC: Therapy Management Corporation
Admissions Case Manager
A nursing home admissions case manager guides patients and families through the transition into long-term or short-term care. They evaluate clinical needs, manage insurance authorizations, and collaborate with hospital staff. This pivotal role ensures a seamless intake process, proper financial planning, and a unified plan of care.
Key Responsibilities
- Clinical Intake & Assessment: Review medical records to ensure the facility can safely and effectively meet the prospective resident's clinical needs.
- Insurance & Financial Verification: Verify insurance benefits (Medicare, Medicaid, private pay), secure prior authorizations, and guide families through financial clearance and paperwork.
- Care Coordination: Act as a liaison between hospital case managers, facility medical directors, nursing staff, and the resident's family to ensure a smooth transition.
- Tour & Inquiry Management: Conduct facility tours for potential residents and families, answering questions about facility life and care standards.
- Regulatory Compliance: Ensure all admission documentation, state regulations, and medical necessity criteria are met.
Skills, Knowledge and Expertise
- Education: Alabama LPN license preferred
- Experience: 1–3 years of experience in long-term care, hospital discharge planning, or clinical intake.
- Skills Needed: Strong working knowledge of Medicare/Medicaid guidelines, excellent interpersonal communication, and familiarity with Electronic Health Record (EHR) systems
About TMC
We specialize in delivering innovative solutions and exceptional services to meet the diverse needs of our clients. With a strong commitment to quality and customer satisfaction, we strive to exceed expectations and drive success in every project we undertake. Apply Now
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