LTACH Admissions Operations Lead

Prime Healthcare; Des Plaines, Northern (IL, KY); Hybrid; USD 84,000 - 113,000; Full time

Benefits offered by this job

401K plan

Medical, dental & vision coverage

Tuition reimbursement

Job summary

Prime Healthcare's Holy Family Medical Center in Des Plaines, IL seeks a full-time LTACH admissions and referral manager within Case Management. This role screens patients for LTACH suitability, coordinates transitions with physicians and care teams, and ensures timely prior authorizations for transfers.

Responsibilities include intake processing, referral tracking, and maintaining accurate data. Experience in Utilization Review and understanding InterQual criteria are preferred.

Qualifications

• Medical or allied health graduate required.
• 2 years of experience in a hospital setting.
• Utilization Review/Management experience preferred.
• Knowledge of InterQual and Milliman criteria preferred.
• Healthcare management experience preferred.
• Knowledge of reimbursement and managed care structures preferred.

Responsibilities

• Lead LTACH admissions and referral management operations.
• Screen and review patients for LTACH appropriateness and level of care.
• Coordinate patient transitions with physicians, case managers and hospital leadership.
• Obtain prior authorizations and facilitate timely transfers with managed care payors.
• Manage referrals, intake, registrations, and discharge data with daily logs.

Skills

Utilization Review

Hospital setting experience

InterQual/Milliman knowledge

Education

Medical Graduate

Dental Graduate

PA

Nursing Graduate

Tools

InterQual criteria

Job description

Prime Healthcare's Holy Family Medical Center in Des Plaines, IL seeks a full-time LTACH admissions and referral manager within Case Management. This role screens patients for LTACH suitability, coordinates transitions with physicians and care teams, and ensures timely prior authorizations for transfers.

Responsibilities include intake processing, referral tracking, and maintaining accurate data. Experience in Utilization Review and understanding InterQual criteria are preferred.