Associate Director, Corporate Partnerships
Equality Now
Account Manager
Limitlessli
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
About the role
- 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.
Requirements
- 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
- Flexible working arrangements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
MDS assessmentscase managementutilization reviewbillingcodingclinical documentationmanaged care processesinsurance authorizationstriple check processpatient care plans
Soft skills
organizational skillscommunication skillsproblem-solving skillsindependent workcollaborative workfast-paced environment
Certifications
Licensed Practical Nurse (LPN)
