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PRN Centralized Intake Referral Manager (Pre-cert Case Manager)

Hinsdale, Illinois 468 - ProMedica Skilled Nursing and Rehabilitation - Hinsdale, IL
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ProMedica is a mission-based, not-for-profit health and well-being organization headquartered in Toledo, Ohio. It serves communities in 26 states. The organization offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 49,000 employees, 12 hospitals, 2,500+ physicians and advanced practice providers with privileges, 1,000+ healthcare providers employed by ProMedica Physicians, a health plan, and senior care services.


ProMedica`s senior care division, formerly known as HCR ManorCare, operates 335+ assisted living facilities, skilled nursing centers, memory care communities and hospice and home health care agencies. Services are provided in 26 states and currently operate under the brand names Heartland, ManorCare, ProMedica and Arden Courts. Over the next 6 months, the senior care entities will continue to rebrand to ProMedica.


Driven by its Mission to improve your health and well-being, ProMedica has been nationally recognized for its advocacy programs and efforts to address and lead in social determinants of health, champion healthy aging and cultivate innovative solutions. For more information about ProMedica senior care services, please visit www.promedicaseniorcare.org.


Description

ProMedica Senior Care provides a range of services, including skilled nursing care, assisted living, post-acute medical and rehabilitation care, hospice care, home health care and rehabilitation therapy.

Job Summary

The PRN Centralized Intake Referral Manager (Precertification Case Manager) is responsible for ensuring patient's meet Skilled Nursing Facility criteria for placement after an acute stay or from the community to prevent re-hospitalizations. The Centralized Intake Referral Manager (Precertification Case Manager) is responsible for working directly with the Managed Care Organizations to obtain approval and assist with patient placement. They are responsible for the Key Account Management for the Managed Care Organizations, daily and monthly reports on efficiency and outcomes.

Educational Requirements

College degree in the health & human service field required. Current, active, and unrestricted licensure or certification in a health or human services discipline preferred.

Position Requirements

Minimum two (2) years experience in medial case management. Comprehensive knowledge of workers' compensation, insurance, and managed care, required. Ability to negotiate coverage and provide complete and timely case mgmt reports, required. Prior experience with an insurance company, private case mgmt. Company, or HMO, preferred. Familiarity with long- term care and/or sub acute care, useful. Strong oral and written communication skills, required.

Category

Nursing - Marketing

Posting ID

011322*IP
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ProMedica Copyright © 2021 ProMedica Senior Care USA, Inc.
All Rights Reserved.

*Equal Opportunity Employer*

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