RN Utilization Management Case Manager (SNF)

Accolade Health Care LLC.; Champaign (IL); Hybrid; USD 75,000 - 90,000; Full time

Benefits offered by this job

Medical, Dental, Vision and voluntary+

401k with company match

Generous Paid Leave Policy

Daily Pay partner

Job summary

Accolade Healthcare in Champaign, IL is seeking a Utilization Management/Case Manager to coordinate the continuum of care with a strong focus on insurance authorizations, case management, and discharge planning. This role ensures services are appropriately authorized and managed to achieve optimal patient and financial outcomes.

The ideal candidate is a licensed RN with at least 2 years of case management experience in SNF or hospital settings, and proficient in insurance processes, CMS

Qualifications

• Licensed RN with case management experience preferred.
• Experience coordinating care for SNF/hospital patients.
• Knowledge of insurance authorizations and CMS guidelines.

Responsibilities

• Coordinate and manage care for SNF caseload with timely authorizations.
• Collaborate with physicians, therapists, social workers, and payors.
• Obtain and manage insurance authorizations for inpatient SNF care.
• Negotiate with payors when needed and respond to denials.
• Develop care plans and ensure compliant documentation.

Skills

RN license

Case management

Insurance authorizations

Communication

Interdisciplinary collaboration

EHR systems

CMS guidelines knowledge

Discharge planning

Caseload management

Negotiation

Education

Registered Nurse (RN) license or equivalent

Tools

Case management software

Medical records software

Job description

Accolade Healthcare in Champaign, IL is seeking a Utilization Management/Case Manager to coordinate the continuum of care with a strong focus on insurance authorizations, case management, and discharge planning. This role ensures services are appropriately authorized and managed to achieve optimal patient and financial outcomes.

The ideal candidate is a licensed RN with at least 2 years of case management experience in SNF or hospital settings, and proficient in insurance processes, CMS