Case Management Nurse
Company Description: Adult Community Educational Services, inc (ACES), is a state licensed, CARF accredited assisted living facility in Wauchula FL. Come join our dynamic healthcare team as a Nurse Program Case Manager, where you will play a vital role in coordinating inpatient care for adult clients who are survivors of traumatic brain injury/neurological impairment, to address the physical and behavioral rehabilitation needs of individual.
• Role Description: The Nurse Case Manager Coordinates with physicians, neuropsychologists, nurses, skilled therapists, behavioral analysts and other members of the clinical team, to ensure clients receive appropriate and efficacious care.
• Responsible for securing continued stay authorization by documenting medical necessity through the utilization review process.
• Maintaining a high degree of communication with clients, guardians, family members, and funding sources.
• Responsible for writing and proofing monthly client clinical service reports within required timeframes.
• Author appeal letters for submission with supporting documentation to insurance entities to reverse inappropriate denials of continued care.
• Ensuring all client/family questions and concerns are addressed and resolved in a timely manner.
Qualifications
• BSN or ADN with 2-3 years' experience in a medical setting.
• Current license to practice Nursing in Florida.
• Previous rehabilitation management and insurance experience is desirable.
• Excellent interpersonal oral and written communication and leadership are required.
• Knowledge of HIPAA regulations and medical records management to ensure confidentiality and compliance.
Medical Practices
Health Care Provider
Full-time