Director Care Coordination RN

Amory Nursing & Rehab Center; Amory (MS); On-site; USD 75,000 - 95,000; Full time

Job summary

Amory Nursing & Rehab Center seeks a seasoned care coordination leader to optimize patient care through efficient admission, care planning, and post-discharge collaboration. You will guide a multidisciplinary team to coordinate resources and ensure timely communication with families and insurers.

Expertise in PDPM, regulatory requirements, and performance of quality measures will drive your day-to-day decisions as you improve outcomes and support a patient-centered culture.

Qualifications

• Degree in nursing, therapy or related clinical field with current license.
• Knowledge of healthcare reimbursement and discharge planning.
• Experience leading teams and projects.
• Ability to develop short and long term strategic plans.
• Strong verbal, written and interpersonal skills.
• Ability to lead a team to achieve outcomes.
• Knowledge of PDPM requirements.
• Understanding regulatory requirements.
• Previous case management experience preferred.

Responsibilities

• Facilitates daily care coordination meetings to align resources with patient needs.
• Participates in Engage/72 HR Admission meetings and coordinates care management.
• Coordinates the restorative nursing program and activity department integration.
• Keeps patients/families informed about changes in condition and discharge plans.
• Communicates with insurance case managers continuously.
• Manages initial, interim, and discharge reviews (Managed Care authorizations).
• Collaborates with clinical team on care plan development and execution.
• Leads patient care rounds/conferences to review treatment and discharge needs.
• Utilizes care management tools (e.g., DartChart) in daily workflows.
• Coordinates discharge planning and post-discharge communication needs.
• Determines non-coverage notification needs and issues beneficiary notices.
• Monitors Quality Measures with care coordination team.
• Ensures Medicare/Managed care regulatory documentation is complete.
• Reviews ADRs with HIMC to ensure documentation is available.

Skills

Leadership

Care coordination

Discharge planning

Communication

Strategic planning

Team management

Regulatory knowledge

PDPM knowledge

Project management

Education

Nursing/therapy clinical degree with license

Tools

DartChart

Managed Care Log

Job description

Overview

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.

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

KEY RESPONSIBILITIES:1. Facilitates daily care coordination meetings to ensure care resources are aligned with benefits andpatient needs2. Participates and facilitates Engage/72 HR Admission meeting. Ensures coordination as part of thecare management system3. Responsible for the coordination of the restorative nursing program including integration of theactivity department4. Ensures timely communication with the patient/family regarding changes in condition and dischargeplanning5. Responsible for the ongoing communication to all insurance case managers6. Manages all initial reviews, interim reviews and discharge reviews (Managed Careauthorizations/reauthorizations).7. Collaborates with clinical team in the development and execution of care plan8. Ensures timely facilitation of patient care rounds/conferences to review treatment plan and identifydischarge and post discharge needs9. Ensures utilization of company tools/resources related to care management – e.g. DartChart/Managed Care Log10. Coordinates discharge planning and post-discharge communication - home health/DME, etc.11. Determines need for non-coverage notification and is responsible for issuance of the beneficiarynotices as well as communication with patients/families/payers12. Monitors Quality Measures along with other members of care coordination team13. Serves as a skilled care documentation specialist ensuring that Medicare and Managed careregulatory guidelines are completed accurately and timely (i.e. certifications, denial letters, skilleddocumentation, coverage criteria, etc.)14. Reviews Additional Documentation Requests (ADRs) with Health Information ManagementCoordinator (HIMC) to ensure all documents are available and meet the request

Qualifications

BACKGROUND QUALIFICATIONS:1. Degree in nursing, therapy or other related clinical field (i.e. social services), must hold a currentlicense in respective field.2. Knowledge of healthcare reimbursement, utilization management, and discharge planning.3. Experience providing strategic leadership, managing teams and leading projects required.4. Ability to formulate and implement short and long term strategic plans5. Strong verbal, written and interpersonal skills.6. Must have proven ability to lead a team to achieve desired outcomes of team7. Strong communication and organizational skills required8. Must have knowledge of PDPM requirements of insurers9. Must have understanding of regulatory requirements10. Previous case management experience preferred

(EOE)