Nurse Case Manager

Job Scope

• Review all new admissions orders.
• Follow up with field RNs to receive SOC reports for all new admissions.
• Send reports on all new admissions to office staff to ensure timely staffing.
• Request authorizations for Kaiser and PPO patients from Billing Department.
• Provide support to field clinicians as needed.
• Keep patient census current and up to date.
• Process any orders for patients on service such as Labs, DMEs, supplies, etc.
• Keep close communication with patients to explain services and answer any questions they may have.
• Document all reports received from field clinicians and take action as necessary.
• Request orders from MD as needed/’Report lab results to MD.
• Participate in the coordination of home health services appropriately reporting the identified needs of patients to the interdisciplinary team which includes PT/OT/MSW/ST/HHA/RN/LVN.
• Track high acuity patients to ensure visits are being done timely and correctly.
• Collaborate with the Staffing team to relay staffing needs for patients and ensure patients have been adequately staffed.
• Review patient’s chart and track progress, determine patient needs throughout the duration of the patient being on service.
• Keep patient’s charts up to date with current tracking and documentation of findings
• Ensure patients get timely services.

Qualifications

• Bachelor’s degree in Nursing (Registered Nurse)
• 6 months to 1-year experience
• Previous HMO/insurance-related work experience is an advantage
• Ideal to have at least 6-months experience in the medical billing/healthcare industry
• Preferably with home healthcare experience
• Professional and excellent English communication skills, phone manners, and writing skills
• Strong attention to detail and resourceful
• Basic computer knowledge, word, emails, excel
• Uphold high ethical standards and moral behavior outlined in the company’s Code of Conduct

Enjoy the following perks and benefits when you work with us

• Cool Workplace
• WEEKENDS OFF!
• Steady-Shift Schedule
• Very Competitive Pay
• Comprehensive HMO
• Monthly Perfect Attendance Bonus & MORE!