Case Management Coordinator – Avery – Needham, MA Job in Needham 02494, Massachusetts Us
Summary: Coordinates clinical operations to ensure compliance with Medicare guidelines and managed care case management policy.
Qualifications:
Education:
§ Graduate of an accredited School of Nursing, BSN preferred.
Licenses/Certification:
§ Valid RN license in the state employed.
Experience:
§ Three years of nursing experience in a long term care environment preferred.
Essential Functions:
§ Identifies Medicare entitlement and eligibility for prospective residents.
§ Completes weekly chart audits to assess documentation support for skilled Medicare coverage.
§ Monitors MDS documentation and charting requirements that support services provided to meeting billing requirements.
§ Charts MDS and pertinent narrative data to optimize case mix scores.
§ Conducts daily assessments of Medicare patients and coordinates therapy, care mapping and discharge planning.
§ Conducts weekly Medicare/case management meetings to review plan of care.
§ Performs other tasks as assigned.
§ Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Knowledge/Skills/Abilities:
§ Ability to work cooperatively as a member of a team.
§ Ability to communicate effectively with residents and their family members, and at all levels of the organization.
§ Knowledge of Medicare regulations
§ Ability to be accurate, concise and detail oriented.
§ Ability to maintain confidentiality.
Service Excellence Requirements:
§ Work efforts reflect a passion for exceeding customer expectations.
§ Solicits patient/resident feedback to understand their needs and the needs of the community. Advocates for Service Excellence within the Center and influences others to take action.
§ Displays responsibility by taking ownership of quality care. Shows dedication to enriching the lives of our patients and residents through empathy and compassion.
§ Exhibits a commitment to results by looking for and recommending/implementing process improvements.
§ Demonstrates commitment to interpersonal excellence through professional greetings, proper telephone etiquette, common courtesy, a professional attitude and appearance.
§ Enriches the Center culture by having fun.
§ Recognizes the benefits of team collaboration. Shows respect for fellow employees by working together to get the job done.
§ Effectively addresses customer concerns and resolves conflict in a manner that is fair to all.