RCM
Core
Coordinate resident care, admissions, discharges, and referrals while communicating with families and providers to ensure safe, cost-effective treatment.
Role type
Licensed Case Manager (Nursing background)
Builds
Resident care plans and utilization review outcomes
Domain
Healthcare / Long-term care facilities
Deliverable
client delivery
Required skills
Utilization review, care coordination, admissions/discharge management, charting, Medicare/Medicaid knowledge, independent judgment, time management
Preferred skills
Registered Nurse (RN) license, Certified Case Manager (CCM), 2+ years clinical nursing experience
Technologies
Electronic health records (implied by charting/computer skills)
Responsibilities
Communicate with residents and families about care plans and treatment protocols; Monitor and adjust resident statuses based on changing needs; Complete required documentation and perform utilization review; Coordinate care with providers, financial services, and third-party payers; Oversee admissions and discharge activities; Coordinate referrals to and from the facility.