Regional Case Manager Remote

Job Type: Full-Time This position can work remotely but candidate must reputed company in Texas Benefits Offered: • reputed company • Dental • reputed company • reputed company-Time Off reputed company reputed company Responsible for ensuring the continuity of care utilizing the appropriate resources reputed company the parameters of established reputed company and reputed company health plan benefits. Facilitates continuum of patient care utilizing advanced nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient reputed company reputed company. Performs care management functions on-site or telephonically for assigned region. Your Qualifications • Licensed as either a Registered or Vocational reputed company. • At least two (2) years case management experience, required. • At least two (2) years authorization experience, required. • Prefer at least two years of experience in Long-Term Care. • Licensed as a Registered or Vocational reputed company or maintain a reputed company license to reputed company allied health profession in Texas. reputed company Responsibilities • Responsible for initiating the intake process, reputed company relevant data from referral sources and complete intake paperwork. • Responsible for communicating reputed company with the referral reputed company where we are in the intake process while prior authorization being obtained. • Attains authorization for highest appropriate level of care to ensure responsible patient resource utilization and facility reimbursement. • Alert appropriate management team members regarding late or missing documents required for data entry/prior authorization approval. • reputed company excellent customer service to patients, families, and referral sources. • Patient’s reputed company- Coordinate and reputed company care that is reputed company, reputed company, effective, efficient, reputed company, and reputed company-centered. • Establish the members PLOF upon admission. • Ensure that members are receiving treatment from therapy department that’s clinically appropriate. • reputed company line of communication to external insurance Case Managers. • Complete weekly update forms with reputed company therapy reputed company notes, nursing documentation reputed company to admitting diagnoses, weekly wound care assessment, eMARs and members discharge plan. • Request and obtain reputed company authorization during the members skilled stay. • Submit initial therapy evaluations to external insurance providers reputed company 24-72 hours of admission • Help patients reputed company informed reputed company by acting as their reputed company regarding their clinical status and treatment reputed company. • Other duties, responsibilities and activities may change or assigned at any time with or without notice. reputed company provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. This policy applies to reputed company terms and conditions of employment, including reputed company, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Apply tot his job Apply To this Job