Legacy Health Services

Manager

• Maintain strong working knowledge of all managed care contracts within assigned areas
• Negotiate appropriate levels of care with contracted and non‑contracted payors
• Coordinate smooth patient transitions and communicate discharge plans to interdisciplinary teams
• Obtain and verify clinical and discharge information from physicians, patients, and payors
• Complete timely reviews, authorizations, and documentation within MCO portals
• Serve as primary point of contact for care coordination throughout the continuum of care
• Participate in interdisciplinary team discussions to support care planning, identify barriers, and monitor progress
• Educate and train new team members on contract terms and case management processes
• Communicate insurance coverage and benefits to patients and families as needed
• Assist with billing reviews, collections support and appeals as appropriate
• Ensure patient confidentiality and compliance with HIPAA and regulatory requirements
• Participate in monthly P&L reviews and support quality improvement initiatives
• Attend required in‑service trainings, orientations, and key account meetings
• Provide coverage for other Case Managers as needed
• Consistently model customer service principles and support the organization’s mission and values

Managed Care Case Manager