Case Manager- Health Center

Arbol Residences of Santa Rosa•San Diego, CA

2h•$38 - $43•Onsite

About The Position

The Case Manager is responsible for coordinating resident care, discharge planning, and communication among residents, families, interdisciplinary team members, payers, and community resources. The Case Manager ensures that residents receive appropriate services to achieve optimal health outcomes while supporting regulatory compliance, care transitions, and resident satisfaction.

Requirements

Strong organizational, communication, and problem-solving skills.

Nice To Haves

Bachelor’s degree in social work, or related field preferred.
Current LVN/LPN, Social Worker, or related healthcare credential preferred.
Minimum 1-2 years of experience in case management, discharge planning, or long-term care.
Knowledge of Medicare, managed care, and skilled nursing regulations preferred.

Responsibilities

Coordinate and monitor resident care plans in collaboration with the interdisciplinary team.
Facilitate communication among physicians, nursing staff, therapists, residents, and family members.
Participate in care plan meetings and ensure resident-centered care goals are established and updated.
Monitor resident progress and identify barriers to achieving care goals.
Develop and implement safe and effective discharge plans.
Coordinate post-discharge services, including home health, hospice, durable medical equipment, transportation, and community resources.
Educate residents and families regarding discharge needs and available resources.
Ensure timely and accurate discharge documentation.
Assist with insurance authorizations and continued stay reviews.
Communicate with managed care organizations and third-party payers regarding resident status and coverage.
Monitor length of stay and assist in achieving appropriate reimbursement and utilization goals.
Track and document payer requirements and authorizations.
Maintain accurate and timely documentation in accordance with facility policies and state and federal regulations.
Participate in Quality Assurance and Performance Improvement (QAPI) activities.
Assist with survey preparation and compliance initiatives.
Ensure adherence to HIPAA and confidentiality standards.
Attend daily clinical meetings, utilization review meetings, and care conferences.
Collaborate with rehabilitation, nursing, dietary, social services, and medical staff to optimize resident outcomes.
Identify opportunities to improve care coordination and reduce avoidable rehospitalizations.