CommuniCare Health Services

Director

• Evaluate facility compliance to clinical policy, procedure, and care
• Visit facilities weekly for intervention, audit, and training
• Train new nursing management
• Monitor readiness for State Survey and assist during surveys
• Aid in Plan of Correction process

Registered Nurse, Mobile Director of Nursing

Therapist

• Evaluate, Review, and Screen patient’s/resident’s medical charts, evaluations under physician order and develop a treatment plan in accordance with patient’s needs.
• Implement treatment plan through direct treatment, as well as education of the plan of care to all team members, including providing necessary supervision for PTAs.
• Attend/Lead interdisciplinary meetings to relay clinical findings and make recommendations to other members of rehab team, as well as conducting staff/family training and education when appropriate.
• Opportunity to work at multiple centers, allowing you to serve a wide variety of patient needs.

Multi-Site Physical Therapist

General

• Assessing, diagnosing, and treating residents in the long-term care facility setting
• Developing personalized treatment plans for individuals with various behavioral health conditions including mood disorders, thought disorders, and substance use disorders
• Serving as leaders in a multidisciplinary team working to enhance the overall well-being of residents
• Conducting thorough behavioral health assessments and evaluations for residents
• Developing and overseeing individualized treatment plans in collaboration with residents, families, and interdisciplinary teams
• Prescribing and managing appropriate medications and therapies tailored to the long-term care setting
• Providing counseling and support to residents and their families
• Monitoring resident progress and adjusting treatment plans as necessary
• Educating residents and staff about behavioral health conditions and available resources within the long-term care setting

Psychiatric Mental Health Nurse Practitioner, PMHNP

Insurance

• Ensure that CommuniCare Medicare Advantage products are the choice for Medicare eligible individuals in their assigned territory
• Use a consultative sales approach to encourage enrollment in a CommuniCare Medicare plan by presenting product options to prospective members
• Follow up on leads and establish relationships with nursing home providers
• Self-generate leads and assist in education and assistance to Medicare-eligible individuals
• Conduct and participate in telemarketing/outreach efforts as required
• Attend sales meetings, training programs, conventions and special events
• Compete applications in a timely, accurate and compliant manner

Insurance Sales Agent

Human Resources

• Support Human Resources operations at 17 facilities
• Facilitate change by anticipating, identifying, planning, and implementing people strategies
• Partner with facilities to achieve human resource goals & objectives
• Deliver employee centric solutions and recruitment strategies
• Work with stakeholders to prioritize work and improve employee experience
• Partner with business groups to understand challenges and implement HR programs
• Coach senior staff members to increase leadership effectiveness
• Ensure timely and accurate data entry, processing, and auditing for assigned facilities
• Travel as necessary to support on-site human resource needs

Regional HR Business Partner

Pharmacist

• Manage real time insurance claims while providing customer service to clients
• Analyze and approve claims that need to be adjudicated
• Determine coverage and apply medical necessity guidelines
• Identify and clarify any discrepancies to complete the adjudication process
• Work in cohesion with the CIC Department, Prior Authorization, and Billing Departments
• Submit claims and add appropriate corrections
• Ensure accurate and timely processing of real time claims
• Work directly with third party payers for claim resolution
• Communicate with facilities on claim issues that will need attention by the facility
• Resolve any discrepancies and secure proper reimbursement
• Any other duties associated with adjudication
• Create Prior Authorizations and notify Authorization team
• Follow federal and state regulations
• Adhere to company policies and procedures
• Follow HIPPA guidelines and regulations

Registered Nurse, Mobile Director of Nursing

Multi-Site Physical Therapist

Psychiatric Mental Health Nurse Practitioner, PMHNP

Insurance Sales Agent

Regional HR Business Partner

Pharmacy Adjudication Specialist