Skilled Nursing LVN Case Manager

The primary purpose this position is to coordinate delivery of services to managed care and Medicare residents in collaboration with the facility’s team members. The Case Manager monitors and documents the cost effectiveness of treatment provided, facilitates and coordinates the admission and discharge process, serves as the resident and family advocate and acts as a liaison to insurance and medical management professionals.

• Communicate resident status, change in function and care plan either by phone or written report to payers.
• Include payer representative in interdisciplinary meetings if requested or deemed necessary to promote payer/provider relationship.
• Document all payer interactions regarding resident progress, expected outcomes and reporting capabilities including special instructions.
• Ensures thorough and timely communication with managed care/insurance case managers to coordinate certification and concurrent stay programs.
• Maximize benefits by coordination of cost effective care, avoid fragmented care and duplication of services and ensure the appropriate level of care is provided in the most suitable setting.
• Meet with facility interdisciplinary team to coordinate services to ensure that the resident’s total regimen of care is maintained.
• Participate in all Medicare and managed care resident interdisciplinary meetings.
• Work with team members to ensure discharge planning goals and objectives are developed and discussed at the interdisciplinary team meetings.
• Work with team members to ensure discharge planning goals and objectives are developed and discussed at the interdisciplinary team meetings.
• Assist in planning the services required in the resident’s discharge plan as necessary.
• Maintain communication with facility business office and medical records to ensure accurate census and payment of managed care and Medicare residents.
• Meet with residents, and/or family members, as necessary. Report problem areas to department directors.

Specific Requirements:

• Must possess a current, unencumbered, active license to practice as an RN or LPN/LVN in this state.
• Must be a supportive team member, contribute to and be an example of team work and team concept.
• Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to managed care and nursing care facilities.
• Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.
• Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents.
• Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.