Case Manager

Cadia Healthcare-Maryland - Hyattsville, MD

Cadia Healthcare is looking for a Case Manager to come join our dedicated team, who are impacting lives every day, by providing the best care for our patients. The Case Manager plays a pivotal role by helping us maintain a 100% occupancy rate by processing commercial insurance referrals. An eye for detail is key - as you will be responsible for reviewing all clinical and financial documentation to ensure compliance. Are you a people person and team player? Our Case Managers work closely with our admissions team throughout the entire case management process.
Cadia Healthcare stands out as one of the most comprehensive providers of care in the Mid-Atlantic Region. Our unique ability to offer skilled nursing, rehabilitation, physician medicine, mobile imaging, and dialysis, along with pharmacy services allows us to stand out among our competitors. As passionate as we are about the care we provide, we are just as passionate about our employees. We provide a dynamic work environment, while investing in our employees to promote their career growth.

Your Contribution:
  • By completing clinical reviews and assessments, we'll be able to determine the resident's clinical requirements, appropriate insurance coverage and provide the appropriate services and plan for discharge.
  • When admitting new residents, you'll review records and insurance; while partnering with admission and liaison teams, along with the administrators, to ensure future residents meet admission criteria.
  • With you working with social workers and insurance case managers, you'll coordinate services provided for residents at the facility; arranging resources, including transportation and related services.
  • You'll ensure discharge occurs safely and efficiently by coordinating with discharge planners, social workers, and the rehab team to review discharge plans and provide input where appropriate.
  • You'll be able to assist the AR Department, by obtaining relevant financial documentation to resolve billing issues and recommend potential improvement to the billing process where appropriate.
  • By preparing monthly pharmacy billing and rates for the AR department for all commercial insurance patients, you'll be able to ensure effective billing.
  • Must possess Registered Nurse License or LPN
  • Case management experience within a Nursing Home, Hospital and other health care setting is preferred but willing to train
  • Experience with Insurance, billing, or insurance requirements; familiarity with third-party payers and medical terminology
  • Proficient in Microsoft Office/Excel with basic knowledge of formulas, charts, and tables
  • Ability to work and multi-task in a fast-paced environment with frequent interruptions
  • Must possess excellent verbal, written and interpersonal communication skills.
  • Detail oriented and organization skills are a must