Case Manager - Skilled Nursing Facility

About Us

Centrally located in Torrance, California, Sunnyside Nursing and Post-Acute Care provides sub-acute nursing care, rehabilitation services, skilled nursing, and long-term care. Our compassionate staff offers individualized care plans for each resident to ensure personalized care is provided to all our patients with a goal to return home.

Our team of qualified professionals provides compassionate care by:

• Maintaining high medical integrity
• Fostering a team spirit among staff
• Creating friendly, beautiful surroundings for our residents and their visitors

We understand the importance of creating a comfortable and nurturing atmosphere, whether residents stay for short-term treatment or long-term care.

Case Manager coordinates the delivery of nursing and rehabilitation services to patients/residents in collaboration with the facility’s care staff. Continually monitors and documents the cost-effectiveness of treatments provided, facilitating admission and discharge processes, serving as patient advocate and liaison to insurance carriers, physicians, health plan case managers and social workers, and other medical management professionals.

Job Description

• Act as the liaison between the clinical staff and the HMOs
• Verify coverage & benefits with the HMO's to ensure proper compensation
• Assist in ordering equipment, updating HMO tracking calendar and logs, etc.
• Update tracking for nursing and therapists, get signatures and approvals for equipment and script
• Obtain and following up on authorization for services
• Greet new residents ensuing a positive admission experience
• Evaluate and communicate resident status, changes in functions and care plans to Health Plans and IDT
• Document all payer interactions regarding resident progress, expected outcomes and special instructions
• Meet with interdisciplinary team to coordinate services ensuring resident’s total regimen of care is maintained
• Coordinate and communicate with business office and medical records to ensure accurate census and payment of managed care and Medicare residents
• Attend scheduled meetings and care rounds

Requirements

• Current LVN license or
• Bachelor's degree in social work, psychology or related human services field and at least 1 year post BA/BS paid work experience
• Prior case managment experience at skilled nursing, acute care, or health plans.
• Ability to understand and interpret medical terminology, diagnoses, and contracts
• Ability to read or quickly pick up reading clinical charts
• Clinical background as an LVN and/or experience in a medical office
• Excellent Microsoft skills - Excel/ Google Suite
• Strong written & verbal communication skills
• Experience with PCC

Ideal Candidate:

• Hard working individual licensed as LVN or has experience and knowledge with medical terminology who is passionate about delivery of quality care and customer services to clients

Shift:

Full-Time

Monday - Friday

8:00 am - 5:00 pm

Benefits

Why Work for Sunnyside Nursing & Post-Acute Care

• Top of the market wages: $22.00 - $35.00 per hour
• Paid orientation and training
• Opportunities for growth
• Loving and caring work environment

We take great pride in meeting or exceeding CDC and CMS standards. On-site experts provide teaching, coaching, and support on infection prevention practices. In addition, we maintain an abundant supply of PPE, including N95/KN95 masks, for all who provide care and services to our patients and residents. Our multiple testing capabilities, including Point-of-Care (POC) testing, are available at every location and comply with CMS and local guidance

If hired, we require that all employees be vaccinated, unless a medical or religious accommodation is needed.

EQUAL OPPORTUNITY EMPLOYER

We are an equal opportunity employer. We celebrate diversity & pride ourselves on creating an inclusive environment for all employees and residents.