Responsibilities/Summary:

Reporting to the Director of Managed Care, the Managed Care Intake Coordinator facilitates the managed care admissions process to client skilled nursing facilities by being the focal point of incoming referrals from multiple locations in Texas. Responsible for review of referrals for skilled need, timely submission to MCO’s for authorization receipt of authorizations from MCOs, follow up for placement at SNF and distribution of correct authorization information to facilities, RCMs and CBO.

Assures a seamless transition for the referral source and patient from the time of referral through admission by ensuring all managed care departmental processes and communications have been completed and are in place.

Knowledgeable of managed care concepts and models, healthcare delivery systems, utilization management and cost containment.

Acts as an advocate for individual’s health care needs to determine the appropriate level of care in the health care continuum.

Knows Medicare, Medicaid and Managed Care criteria and requirements for SNF.

Understands the importance of working as a team member to support internal functions and responsibilities of the Case Management Department. Must have superior written and oral communication skills and the desire to work as a team within the department as well as with client facilities for the patients we serve.

Qualifications:

Able to organize and prioritize many tasks efficiently and manage deadlines effectively

Knowledgeable of patient/resident rights related to access of insurance policy terms and limitations

Must be knowledgeable of HIPPA regulations

Two (2) Plus years combined marketing, managed care and/or case management experience with primary focus in Skilled Nursing Facilities, Managed Care and Long Term Care

Must have above average computer skills – MS Office, Excel and Outlook

Must have excellent communication skills, both written and oral coupled with superior telephone etiquette

BENEFITS:

All of our employees are valued and receive a competitive wage; full time team members are also offered a comprehensive benefit package which includes:

Drug Free, Smoke-Free work place, Equal Opportunity Employer, including disability/vets