Westminster Woods on Julington Creek is the Natural Choice in active living. We are a faith-based, not-for-profit organization inspired by a mission of serving older adults.  Our five star facility is located in Northwest St. Johns County.  We are currently seeking a full-time Case Management Liaison. This position performs clinical assessments for potential and current Westminster Services health center residents. Negotiation for residents who are clients of managed care organizations. Liaise between community relations, discharge planners, and Physicians. Must support the Marketing efforts at the community. Maximize cost effectiveness across the entire continuum of care; improve customer satisfaction and enhance quality of care. EEO/DFWP "We honor those who have served."

ESSENTIAL JOB FUNCTIONS: Comply with all applicable rules, standards and guidelines related to employment with Westminster Services and its communities.

1. Works as community liaison for referrals from physician, hospitals, insurance based case manager, or marketing personnel on all potential sub-acute patients, ensures initial and on-going fiscal appropriateness of member admissions in conjunction with Business Office and Director of Nursing.

2. Assists the community with tracking of authorization numbers of residents on Managed Medicaid and other Managed Care Insurance plans.

3. Works with community staff to monitor and track resident's progress and communicate relevant information between resident, referrer, family, insurance company, and treatment team, communicates with the interdisciplinary member care team.

4. Works with residents, families and other staff as needed to ensure that residents are evaluated for the appropriate level of care.

5. Assists with coordination, monitoring, and communication of resident’s progress and costs.

6. Fosters positive relationships with insurance representatives and physicians in the local market.

7. Address quality measures issues for potential admissions and returning residents.

8. Complete Pre-Admission process in EHR for new admissions.

The above job description is not to be construed as a complete listing of the assignments and responsibilities assigned to any employees; nor are such assignments restricted to those precisely listed in this description. This job description may change from time to time as the needs of the organization change.

ESSENTIAL QUALIFICATIONS:

Education/Licensure: Must be a licensed RN in the state of Florida; or a degree in a related field. Certification in Case Management or Geriatrics preferred. Must be CPR Certified.

Experience: Two years in long term care and assisted living, including working knowledge of Medicare and Managed care and Managed Medicaid protocols. One year in post acute rehabilitation. Case management purpose and process knowledge required. Demonstrated clinical assessment skills required.

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