Admissions Case Manager for SNF

Overview

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.


Responsibilities

Core 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.

Qualifications

Qualifications:

• • 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