Responsible for coordinating home care services for managed care patients, which includes establishing and maintaining the patient’s plan of care, establishing and maintaining positive relationships with managed care customers and related referral sources, and negotiating service agreements.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
- 1. Coordinates home care services for managed care patients, assists with the establishment of the plan of care in coordination with the physician and insurance Case Managers, and ensures a seamless transition to home care.
- 2. Collaborates with inpatient utilization review departments and managed care Case Managers to facilitate safe, early inpatient discharge.
- 3. Verifies insurance coverage and obtains initial authorizations for services and seeks reauthorization for ongoing and additional services.
- 4. Works with Clinical Supervisors/Nursing Supervisors and staff clinicians to gather, collate, and report patient care summary information to managed care Case Managers.
- 5. Promotes maximum third party reimbursement through price negotiations with managed care Case Managers, within the established financial, credit, and contractual parameters.
- 6. Maintains comprehensive working knowledge of managed care contractual relationships and ensures that patients are admitted and services are delivered in accordance with contract provisions.
- 7. Works with members of the billing team to ensure that managed care customers are billed according to Case Manager agreements.
- 8. Establishes and maintains positive working relationships with current and potential managed care customers.
- 9. Promptly responds to managed care customer’s requests and concerns.
- 10. Assists in building community, customer, payer and patient perceptions of Human Touch Palliative and Hospice Care, Inc. as a high quality provider of services.
- 11. Maintains comprehensive working knowledge in the field of managed care and shares information with appropriate organization personnel. Job Title/Position: LVN Care Coordinator
- 12. Maintains comprehensive working knowledge of community resources and assists customers in accessing community resources should services not be provided by Human Touch Palliative and Hospice Care, Inc.
The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description
Job Type: Full-time
Pay: $20.00 - $54.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Day shift
- Monday to Friday
- On call
Ability to commute/relocate:
- Manhattan Beach, CA 90266: Reliably commute or planning to relocate before starting work (Required)
License/Certification:
- LVN (Preferred)
- BLS Certification (Preferred)
- LPN (Required)
Work Location: In person
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