Senior SNF Utilization & Case Manager

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

Benefits offered by this job

Medical, Dental, Vision

401k with company match

Paid Leave Policy

Daily Pay partner

Job summary

Accolade Healthcare in Champaign, IL seeks a Utilization Management/Case Manager to coordinate care, secure insurance authorizations, and plan discharges for SNF patients. You will work with physicians, therapists, social workers, and payors to ensure timely approvals and smooth transitions while maintaining regulatory compliance.

The role requires an RN or equivalent credential and 2+ years in case management, with strong knowledge of CMS guidelines and EHR systems.

Qualifications

• Licensed RN or equivalent clinical credential preferred.
• Minimum 2 years of case management experience, preferably in SNF, hospital, or managed care.
• Strong knowledge of insurance authorization processes and appeal strategies.
• Experience with Single Case Agreements, Workman’s Comp, and No-Fault contracts.

Responsibilities

• Coordinate and manage care for a caseload of SNF patients with timely authorizations and ongoing stay approvals.
• Collaborate with interdisciplinary teams to promote seamless transitions and quality care.
• Obtain and manage insurance authorizations for inpatient SNF care across commercial, Medicare Advantage, Medicaid, WC, No-Fault, and SCA.
• Negotiate reimbursement rates for non-contracted payors when necessary.
• Review denials and discrepancies; prepare appeals and participate in health plan appeals as needed.
• Identify patient care needs and develop appropriate care plans with the healthcare team.
• Advocate for patient access to services while ensuring compliance with insurance guidelines.
• Maintain accurate documentation per facility, insurance, and regulatory standards.

Skills

RN license

Case management

Insurance authorization

CMS guidelines

EMR/EHR

Communication

Collaboration

Negotiation

Education

RN or equivalent

Tools

EMR/EHR

Job description

Accolade Healthcare in Champaign, IL seeks a Utilization Management/Case Manager to coordinate care, secure insurance authorizations, and plan discharges for SNF patients. You will work with physicians, therapists, social workers, and payors to ensure timely approvals and smooth transitions while maintaining regulatory compliance.

The role requires an RN or equivalent credential and 2+ years in case management, with strong knowledge of CMS guidelines and EHR systems.