Managed Care Case Manager, VNA of Cape Cod
Conducts weekly IDT meetings with each POD on all managed care patients
Organizes, directs, coordinates and evaluates the activities related to patient management.
Manage benefits for best interest of home care agency and patients
Reviews records to prevent denials and submits all required documentation in a timely manner
Manage multi payer scenarios with logical plans of care and services
Provide clinical expertise and serve as a resource to staff
Conduct team meetings and participate in interdisciplinary case conferences.
Complete performance evaluations in a timely manner
Remove barriers to managed care patient discharge
Problem solve financial and medical issues and patient complaints
Reviews clinical records for medical necessity, level of care and appropriateness
All other duties as assigned.
Current LPN license in Massachusetts or Certified Occupational Therapy Assistant (COTA)
Minimum eight (8) years clinical experience including two (2) in homecare/community preferred, health required and liaison experience a plus
Computer skills preferred.