Director Care Coordination RN

Amory Nursing & Rehab Center•Amory, MS

3d•Onsite

About The Position

Smile, You’ve Found Us! Are you passionate about caregiving? Would you like to work with the best team in the world? If so, Diversicare invites you to apply. We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence, which we extend to all those we are privileged to serve. If you wish to make a difference in the lives of our patients and residents, APPLY NOW! Diversicare provides post-acute care services to patients and residents at 61 skilled nursing and long-term care centers in eight states, primarily in the Southeast, Midwest and Southwest United States. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs. It is Diversicare’s Mission to “Improve every life we touch by providing exceptional healthcare and exceeding expectations.” We are guided to来excellence by five Core Values: Integrity, Excellence, Compassion, Teamwork and Stewardship, as well as 12 Service Standards. We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence. Our Service Standards are in place to offer support. They lead us to what matters most to our company: creating a warm, caring, safe and professional environment for our customers and each other. Our culture of impassioned service delivery is the Diversicare Difference.

Requirements

Degree in nursing, therapy or other related clinical field (i.e. social services), must hold a current license in respective field.
Knowledge of healthcare reimbursement, utilization management, and discharge planning.
Experience providing strategic leadership, managing teams and leading projects required.
Ability to formulate and implement short and long term strategic plans
Strong verbal, written and interpersonal skills.
Must have proven ability to lead a team to achieve desired outcomes of team
Strong communication and organizational skills required
Must have knowledge of PDPM requirements of insurers
Must have understanding of regulatory requirements

Nice To Haves

Previous case management experience preferred

Responsibilities

Facilitates daily care coordination meetings to ensure care resources are aligned with benefits and patient needs
Participates and facilitates Engage/72 HR Admission meeting. Ensures coordination as part of the care management system
Responsible for the coordination of the restorative nursing program including integration of the activity department
Ensures timely communication with the patient/family regarding changes in condition and discharge planning
Responsible for the ongoing communication to all insurance case managers
Manages all initial reviews, interim reviews and discharge reviews (Managed Care authorizations/reauthorizations)
Collaborates with clinical team in the development and execution of care plan
Ensures timely facilitation of patient care rounds/conferences to review treatment plan and identify discharge and post discharge needs
Ensures utilization of company tools/resources related to care management – e.g. DartChart/Managed Care Log
Coordinates discharge planning and post-discharge communication - home health/DME, etc.
Determines need for non-coverage notification and is responsible for issuance of the beneficiary notices as well as communication with patients/families/payers
Monitors Quality Measures along with other members of care coordination team
Serves as a skilled care documentation specialist ensuring that Medicare and Managed care regulatory guidelines are completed accurately and timely (i.e. certifications, denial letters, skilled documentation, coverage criteria, etc.)
Reviews Additional Documentation Requests (ADRs) with Health Information Management Coordinator (HIMC) to ensure all documents are available and meet the request