Managed Care Case Manager, VNA of Cape Cod
Cape Cod Healthcare•Hyannis, MA
About The Position
The Managed Care Case Manager at VNA of Cape Cod is responsible for overseeing patient management activities, ensuring optimal care, and managing financial and medical aspects of patient cases. This role involves coordinating with various teams, reviewing patient records, and acting as a clinical resource.
Requirements
- Current LPN license in Massachusetts or Certified Occupational Therapy Assistant (COTA)
- Minimum eight (8) years clinical experience including two (2) in homecare/community preferred, health required and liaison experience a plus
- Computer skills preferred.
Responsibilities
- Conducts weekly IDT meetings with each POD on all managed care patients
- Organizes, directs, coordinates and evaluates the activities related to patient management.
- Manage benefits for best interest of home care agency and patients
- Reviews records to prevent denials and submits all required documentation in a timely manner
- Manage multi payer scenarios with logical plans of care and services
- Provide clinical expertise and serve as a resource to staff
- Conduct team meetings and participate in interdisciplinary case conferences.
- Complete performance evaluations in a timely manner
- Remove barriers to managed care patient discharge
- Problem solve financial and medical issues and patient complaints
- Reviews clinical records for medical necessity, level of care and appropriateness
- All other duties as assigned.
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What This Job Offers
Career Level
Senior
Education Level
No Education Listed
Number of Employees
501-1,000 employees
