RN/LPN Regional Case Manager

FutureCare•Glen Burnie, MD

About The Position

At FutureCare our Regional Case Managers are part of our interdisciplinary team of nurses who are the vital link between negotiating or confirming managed care rates, assuring adequacy of financial support prior to admission, and ongoing through continued authorization. Under the direction of the Vice President of Marketing and Business Development, our Regional Case Managers serves a liaison between our residents, physicians, care team members, and family by coordinating, monitoring, and communicating the resident’s progress and services. Proud to be the only healthcare company in Baltimore to be named a “Top Workplace” for 14 years in a row and recognized in US Newsweek as “Best Nursing Homes”, FutureCare stands out as a leader in managing health care across a continuum of care. We are known for recognizing hard work and dedication and reward our team members for their compassion and care. We also offer a Competitive Salary, Excellent Benefits Package, Flex/Advance Pay, Paid Time Off, Tuition Reimbursement, Career Growth Ladder, Employee Referral Bonus Program, Employee Assistance, and matching 401K Plan. Salary Disclosure Statement The salary mentioned above reflects the potential base pay range for this role. Bonuses or other incentives (if applicable) are offered separately and paid pursuant to the relevant program schedule. All employment offers will consider such factors as overall experience, job-related qualifications, location, certifications/training, etc.

Requirements

Must have a current LPN or RN license registered with the Maryland Board of Nursing
Minimum of 3 years clinical experience or 2 years’ experience in medical case management
Must possess negotiation skills with insurance coverage and the ability to provide complete and timely case management reports as required
Must be able to travel between multiple facility locations
Strong oral and written communication skills required

Nice To Haves

Comprehensive knowledge of worker’s compensation insurance and managed care highly preferred
Familiarity with long-term care and/or sub-acute care is helpful

Responsibilities

Contact payer source to determine or verify coverage and adequate funding for required resident services
Perform rate calculations based on resident service needs and contract with payer source for continued authorization level of services
Coordinate resident’s smooth transition through FurtureCare’s sub-acute program
Provide accurate communication to our care team on resident’s information pertaining to treatment plans, resident progress and expected discharge plans
Document all contract and payer information as required timely to the treatment team and business office billing staff
Develop referrals from case managers, insurance companies and utilization review nurses
Present FutureCare programs of services offered to Managed Care referred sources through “Lunch & Learn” presentations to insurance companies, self-insured industry partners, physicians, etc.
Attend regional meeting, scheduled in-service programs, PPS meetings, and all other required meetings