Case Manager - Skilled Nursing Facility

About Us
Centrally located in Torrance, California, Sunnyside Nursing and Post-Acute Care provides sub-acute nursing care, rehabilitation services, skilled nursing, and long-term care. Our compassionate staff offers individualized care plans for each resident to ensure personalized care is provided to all our patients with a goal to return home.
Our team of qualified professionals provides compassionate care by:
Maintaining high medical integrity
Fostering a team spirit among staff
Creating friendly, beautiful surroundings for our residents and their visitors
We understand the importance of creating a comfortable and nurturing atmosphere, whether residents stay for short-term treatment or long-term care.
Case Manager coordinates the delivery of nursing and rehabilitation services to patients/residents in collaboration with the facility’s care staff. Continually monitors and documents the cost-effectiveness of treatments provided, facilitating admission and discharge processes, serving as patient advocate and liaison to insurance carriers, physicians, health plan case managers and social workers, and other medical management professionals.
Job Description
Act as the liaison between the clinical staff and the HMOs
Verify coverage &
benefits with the HMO'sto ensure proper compensation
Assist in ordering equipment, updating HMO tracking calendar and logs, etc.
Update tracking for nursing and therapists, get signatures and approvals for equipment and script
Obtain and following up on authorization for services
Greet new residents ensuing a positive admission experience
Evaluate and communicate resident status, changes in functions and care plans to Health Plans and IDT
Document all payer interactions regarding resident progress, expected outcomes and special instructions
Meet with interdisciplinary team to coordinate services ensuring resident’s total regimen of care is maintained
Coordinate and communicate with business office and medical records to ensure accurate census and payment of managed care and Medicare residents
Attend scheduled meetings and care rounds
Requirements
Current LVN license or
Bachelor's degree in social work, psychology or related human services field and at least 1 year post BA/BS paid work experience
Prior case managment experience at skilled nursing, acute care, or health plans.
Ability to understand and interpret medical terminology, diagnoses, and contracts
Ability to read or quickly pick up reading clinical charts
Clinical background as an LVN and/or experience in a medical office
Excellent Microsoft skills - Excel/ Google Suite
Strong written &
verbal communication skills
Experience with PCC
Ideal Candidate:
Hard working individual licensed as LVN or has experience and knowledge with medical terminology who is passionate about delivery of quality care and customer services to clients
Shift:
Full-Time
Monday - Friday
8:
00 am - 5:
00 pm
Benefits
Why Work for Sunnyside Nursing &
Post-Acute Care
Top of the market wages:
$22.00 - $35.00 per hour
Paid orientation and training
Opportunities for growth
Loving and caring work environment
We take great pride in meeting or exceeding CDC and CMS standards. On-site experts provide teaching, coaching, and support on infection prevention practices. In addition, we maintain an abundant supply of PPE, including N95/KN95 masks, for all who provide care and services to our patients and residents. Our multiple testing capabilities, including Point-of-Care (POC) testing, are available at every location and comply with CMS and local guidance
If hired, we require that all employees be vaccinated, unless a medical or religious accommodation is needed.
EQUAL OPPORTUNITY EMPLOYER
We are an equal opportunity employer. We celebrate diversity &
pride ourselves on creating an inclusive environment for all employees and residents.