Registered Nurse - Case Manager - Remote | WFH

Summary

The Clinical Liaison maintains regular and ongoing relationships with Skilled Nursing Facilities (SNFs) and Home Health Agencies (HHAs) to foster strong, trustworthy, and professional partnerships. The role aims to enhance overall post-acute cost of care efficiency and improve patient satisfaction and quality.

Minimum Qualifications

Education: Graduate of an accredited school of nursing (Associates or Bachelor's degree in Nursing)

Licenses/Certifications: Current, unrestricted Registered Nurse licensure

Experience/Knowledge/Skills

1-2 years of experience in post-acute care, preferably in a Health Plan or SNF setting

Familiarity with utilization management and CMS criteria

Ability to perform utilization reviews using evidence-based criteria

Collaboration with Hospital Acute Case Management, SNFs, and HHAs to assess medical necessity and appropriateness of care settings

Remote position; no home health visits required

This position collaborates closely with Hospital Acute Case Management, SNFs, and HHAs to ensure optimal care placement and timing, leveraging evidence-based criteria to achieve desired performance outcomes.

Employment Type: Full-Time