Case Management Nurse

Company Description Adult Community Educational Services, inc (ACES), is a state licensed, CARF accredited assisted living facility in Wauchula FL. Come join our dynamic healthcare team as a Nurse Program Case Manager, where you will play a vital role in coordinating inpatient care for adult clients who are survivors of traumatic brain injury/neurological impairment, to address the physical and behavioral rehabilitation needs of individual. Responsibilities Role Description: The Nurse Case Manager Coordinates with physicians, neuropsychologists, nurses, skilled therapists, behavioral analysts and other members of the clinical team, to ensure clients receive appropriate and efficacious care. Responsible for securing continued stay authorization by documenting medical necessity through the utilization review process. Maintaining a high degree of communication with clients, guardians, family members, and funding sources. Responsible for writing and proofing monthly client clinical service reports within required timeframes. Author appeal letters for submission with supporting documentation to insurance entities to reverse inappropriate denials of continued care. Ensuring all client/family questions and concerns are addressed and resolved in a timely manner. Qualifications BSN or ADN with 2-3 years' experience in a medical setting. Current license to practice Nursing in Florida. Previous rehabilitation management and insurance experience is desirable. Excellent interpersonal oral and written communication and leadership are required. Knowledge of HIPAA regulations and medical records management to ensure confidentiality and compliance. #J-18808-Ljbffr