Director of Case Management

Majestic Care is looking for a Director of Case Management to join our teams’ mission and believe in our core values!

Our mission :   Through the hearts of our Care Team Members, we provide excellent healthcare to those we serve.

Our Core Values...

L - Listening

E - Empathy

A - Accountability

D - Decisiveness

This is how we create a culture to LEAD with Love.

POSITION SUMMARY :

Through the hearts and minds of our care team members, we provide excellent healthcare to those we serve.   With a vision of innovating healthcare by keeping those we serve at the heart of our mission, we provide tools, processes, support resources, data analytics and insource strategies that drive results.   The Director of Case Management plays a vital role in shaping and executing the strategy that will ensure the highest standards of patient care and Safety.

Responsibilities

Supervision of Case Managers and Prior Authorization Specialist (D / C Follow Up) including education, monitoring and auditing.

Tracking of Case Managers’ KPI's.

Support with contracting and credentialing.

Support managed care audits performing education as well as monitoring and auditing.

Manage territory distribution.

Work closely with ISNP programs to ensure capture of all revenues including education, monitoring and auditing.

Educate and support CM, Intake, Compliance on managed care, contracts and importance of management.

Support VP of Case Management and Managed Care Reimbursement.

Skills and Qualifications

Experience as SNF Case Manager or Regional SNF case manager.

Experience gaining authorizations for all SNF lines of business.

Experience managing a team.

Experience with EMR (PCC), Availity, insurance company portals, etc.

Deep understanding of how Medicare and Medicare advantage plans work in the SNF environment

Flexible, hardworking, understands that we are building a department.

#LoMed