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Clinical MDS Account Manager
LimitlessliClinical MDS Account Manager at Limitlessli coordinating patient care and ensuring compliance with regulatory guidelines. Leveraging strong clinical judgment and collaboration across interdisciplinary teams in remote healthcare.
About the role
Key responsibilities & impact- Hold the client relationship, communication and reporting for assigned clients.
- Coordinate and oversee patient care plans in collaboration with physicians, therapists, and nursing staff.
- Manage MDS (Minimum Data Set) assessments to ensure timely and accurate submission in accordance with federal and state regulations.
- Review, monitor, and manage managed care authorizations, ensuring patients receive appropriate and approved services.
- Participate in triple check processes to ensure accuracy of billing, coding, and clinical documentation.
- Communicate regularly with insurance providers, patients, and families regarding care plans and coverage.
- Monitor patient progress, outcomes, and transitions of care to reduce readmissions and optimize quality of care.
- Maintain compliance with regulatory requirements, company policies, and professional standards.
- Serve as a resource for staff education and training related to managed care, MDS, and documentation standards.
- Assist with audits, reporting, and quality assurance initiatives.
Requirements
What you’ll need- Current Licensed Practical Nurse (LPN) in good standing [State-specific license required].
- Minimum of 2+ years of experience in case management, utilization review, or related nursing role.
- Hands-on experience with MDS assessments and knowledge of CMS guidelines.
- Knowledge and prior experience in managed care processes and insurance authorizations.
- Familiarity with triple check process for billing and reimbursement.
- Strong organizational, communication, and problem-solving skills.
- Ability to work independently and collaboratively in a fast-paced healthcare environment.
- Proficient in electronic medical records (EMR) systems and Microsoft Office Suite.
Benefits
Comp & perks- Flexible working arrangements
- Work from home options
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Case ManagementUtilization ReviewBilling and CodingQuality AssurancePatient Care Coordination
Soft Skills
Organizational SkillsCommunication SkillsProblem-Solving Skills
Certifications
Licensed Practical Nurse (LPN)