Utilization Management RN - Care Coordination

Signature HealthCARE, LLC; Louisville (KY); On-site; USD 75,000 - 82,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) and Roth 401(k)

Tuition reimbursement

PTO and paid holidays

Telemedicine services

Job summary

Signature HealthCARE, LLC in Louisville, KY seeks an experienced RN Case Manager to coordinate care with Managed Care Organizations and internal teams. You will assess resident needs, authorize services, and ensure accurate reporting and billing.

A strong background in case management and Medicare/MDS is essential for success in this role. The position offers full-time hours, opportunities for professional growth, and a comprehensive benefits package.

Qualifications

• RN licensure required and in good standing.
• Associate degree in Nursing or higher required; Bachelor's preferred.

Responsibilities

• Collaborate with MCOs and care teams to ensure appropriate setting and timing of services.
• Assess resident care needs and communicate clearly to MCO; authorize services and address outliers.
• Coordinate discharge planning with agencies and health care organizations.
• Document authorizations and continued stay activity in Case Management software for billing.
• Prepare Managed Care documentation to ensure accurate facility billing.

Skills

RN licensure

Case management

Medicare/MDS knowledge

Hospital/SNF/Acute Rehab experience

Education

Nursing license (RN)

Associate degree in Nursing

Bachelor's degree preferred

Tools

Case Management software

MDS RUG system

Job description

Signature HealthCARE, LLC in Louisville, KY seeks an experienced RN Case Manager to coordinate care with Managed Care Organizations and internal teams. You will assess resident needs, authorize services, and ensure accurate reporting and billing.

A strong background in case management and Medicare/MDS is essential for success in this role. The position offers full-time hours, opportunities for professional growth, and a comprehensive benefits package.