Director Care Coordination RN

Diversicare Healthcare Services, LLC; Amory (MS); On-site; USD 70,000 - 90,000; Full time

Job summary

Diversicare is seeking a skilled Care Coordination Leader to oversee patient care planning, discharge planning, and regulatory compliance across our Mississippi facilities. You will lead care teams, coordinate transitions, and ensure service excellence in post-acute settings.

The role requires a nursing or related clinical degree with a current license, strong leadership and communication skills, and experience with PDPM requirements and managed care processes.

Qualifications

• Degree in nursing or related clinical field with current license.
• Knowledge of healthcare reimbursement, utilization management, and discharge planning.
• Experience leading teams and projects in healthcare.
• Strong strategic planning and organizational skills.

Responsibilities

• Facilitate daily care coordination meetings to align resources with patient needs.
• Lead Engage/72 HR Admission meetings and coordinate care plans.
• Oversee restorative nursing integration with activities.
• Communicate changes in condition and discharge plans to patient and family.
• Coordinate with insurance case managers and manage reviews.
• Collaborate with clinical team to develop and execute care plans.
• Ensure timely patient rounds and post-discharge planning.
• Monitor quality measures with care coordination team.

Skills

Leadership

Communication

Team management

Care coordination

Regulatory knowledge

Education

Bachelor's degree in nursing or related clinical field

Tools

Dart Chart

Managed Care Log

Job description

Smile, You’ve Found Us!

Are you passionate about caregiving? Would you like to work with the best team in the world? If so, Diversicare invites you to apply.

Overview

We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence, which we extend to all those we are privileged to serve.

If you wish to make a difference in the lives of our patients and residents,

Full Time Benefits Include

• Medical/Dental/Vision
• Excellent 401k plan
• Tuition Reimbursement
• Vacation, Holiday, and Sick Time
• Long and Short Term Disability
• Employee Assistance Program
• Life Insurance
• Referral Bonuses
• DiversICARE - employee hardship fund
• Pay advancement program - OnShift Wallet

Diversicare provides post-acute care services to patients and residents at 61 skilled nursing and long-term care centers in eight states, primarily in the Southeast, Midwest and Southwest United States. Together, with our team of dedicated healthcare professionals, we leverage our diverse strengths to provide each patient and resident with healthcare serves that best meet their needs.

It is Diversicare’s Mission to “Improve every life we touch by providing exceptional healthcare and exceeding expectations.”

We are guided to excellence by five Core Values: Integrity, Excellence, Compassion, Teamwork and Stewardship, as well as 12 Service Standards.

We build on trust, respect, customer focus, compassion, diplomacy, appreciation and strong communication skills to shape the culture in our workplace. Diversicare team members play a critical role in fostering an environment of Service Excellence. Our Service Standards are in place to offer support. They lead us to what matters most to our company: creating a warm, caring, safe and professional environment for our customers and each other.

Our culture of impassioned service delivery is the Diversicare Difference.

#DSC123

Responsibilities

• Facilitates daily care coordination meetings to ensure care resources are aligned with benefits and patient needs
• Participates and facilitates Engage/72 HR Admission meeting. Ensures coordination as part of the care management system
• Responsible for the coordination of the restorative nursing program including integration of the activity department
• Ensures timely communication with the patient/family regarding changes in condition and discharge planning
• Responsible for the ongoing communication to all insurance case managers
• Manages all initial reviews, interim reviews and discharge reviews (Managed Care authorizations/reauthorizations).
• Collaborates with clinical team in the development and execution of care plan
• Ensures timely facilitation of patient care rounds/conferences to review treatment plan and identify discharge and post discharge needs
• Ensures utilization of company tools/resources related to care management – e.g. Dart Chart/Managed Care Log
• Coordinates discharge planning and post-discharge communication - home health/DME, etc.
• Determines need for non-coverage notification and is responsible for issuance of the beneficiary notices as well as communication with patients/families/payers
• Monitors Quality Measures along with other members of care coordination team
• Serves as a skilled care documentation specialist ensuring that Medicare and Managed care regulatory guidelines are completed accurately and timely (i.e. certifications, denial letters, skilled documentation, coverage criteria, etc.)
• Reviews Additional Documentation Requests (ADRs) with Health Information Management Coordinator (HIMC) to ensure all documents are available and meet the request

Qualifications

• Degree in nursing, therapy or other related clinical field (i.e. social services), must hold a current license in respective field.
• Knowledge of healthcare reimbursement, utilization management, and discharge planning.
• Experience providing strategic leadership, managing teams and leading projects required.
• Ability to formulate and implement short and long term strategic plans
• Strong verbal, written and interpersonal skills.
• Must have proven ability to lead a team to achieve desired outcomes of team
• Strong communication and organizational skills required
• Must have knowledge of PDPM requirements of insurers
• Must have understanding of regulatory requirements
• Previous case management experience preferred

(EOE)