Clinical Case Manager

Absolute Authorizations LLC; United States; Remote; USD 22,000 - 26,000; Full time

Job summary

A healthcare organization is seeking a Clinical Case Manager to advocate patient care in Skilled Nursing Facilities. The role requires experience with Managed Care policies, excellent communication skills, and a valid medical license. This is a fully remote position that offers a competitive salary and an opportunity to make a significant impact in patient care.

Qualifications

• Mandatory experience with Skilled Nursing Facilities.
• Strong understanding of managed care processes.
• Ability to read clinical notes.

Responsibilities

• Submit detailed concurrent reviews and appeals highlighting Medical Necessity.
• Procure and maintain accurate tracking of all authorization and payer details.
• Identify and obtain reimbursement opportunities.
• Coordinate communication between Insurance Case Managers and facility clinicians.

Skills

Experience with Skilled Nursing Facilities

Knowledge of SNF Managed Care policies

Excellent verbal and written communication skills

Organizational skills

Knowledgeable in Microsoft Suite

Education

Valid medical license

Clinical experience

Job description

Direct message the job poster from Absolute Authorizations LLC

Chief Executive Officer at Absolute Authorizations LLC

Absolute Authorizations LLC is looking to hire an experienced healthcare clinician for our Clinical Case Manager position. This is a fully remote position advocating patient care in Skilled Nursing Facilities.

MANDATORY EXPERIENCE:

- Experience working with Skilled Nursing Facilities

- Working knowledge reading clinical notes

- Obtaining Authorizations for Skilled Nursing Facility care

Responsibilities:

1.Submit detailed concurrent reviews and appeals highlighting Medical Necessity

2.Procure and maintain accurate tracking of all authorization and payer details

3.Identify and obtain reimbursement opportunities

4.Routinely correspond all outstanding billing details to Facility

5.Provide temporary case management coverage as needed

6.Coordinate and streamline communication between Insurance Case Managers and facility clinicians

7.Serve as the primary point of contact and support for Facility staff addressing issues, questions, or concerns regarding their Managed Care population.

Qualifications:

1.Knowledge of SNF Managed Care policies, procedures and processes.

3.Experience in a Skilled Nursing Facility setting

4.Valid medical license and clinical experience

5.Excellent verbal and written communication skills

6.Organizational skills

7.Knowledgeable in Microsoft Suite and computer skills

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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