Case Manager- Health Center

Position: Case Manager- Health Center

Pay Rate: $38-$43 hourly

Who we are:

Experience the future of senior living and care as soon as you step foot into our doors. Casa de las Campanas offers upscale resort-style living in the scenic area of Rancho Bernardo. Our team of dedicated professionals strives to improve the lives of seniors in our community on a daily basis. Our campus and surroundings reflect the love that our residents have for southern California. Our unique combination of an all-inclusive lifestyle, exceptional hospitality, and stunning location is unmatched. Our well-traveled and outdoorsy senior community enjoys socializing over meals, exploring nearby trails, and taking in breathtaking views. We are currently seeking a talented Case Manager for our Health Center. If you want to experience a fresh perspective on Healthcare and Senior Living, join us today!

You will enjoy:

• $0 employee cost share for medical insurance
• Dental and Vision Insurance
• Bonus eligibility
• Now offering DailyPay!
• Life insurance
• 403 (b) retirement plan with employer match
• Tuition reimbursement program funded by our residents
• PTO and paid holidays
• Pet insurance
• AFLAC
• An exceptional work environment that is both engaging and fun!
• Long-term disability insurance

Who you are:

• Bachelor's degree in social work, or related field preferred.
• Current LVN/LPN, Social Worker, or related healthcare credential preferred.
• Minimum 1-2 years of experience in case management, discharge planning, or long-term care.
• Knowledge of Medicare, managed care, and skilled nursing regulations preferred.
• Strong organizational, communication, and problem-solving skills.

Position Summary

The Case Manager is responsible for coordinating resident care, discharge planning, and communication among residents, families, interdisciplinary team members, payers, and community resources. The Case Manager ensures that residents receive appropriate services to achieve optimal health outcomes while supporting regulatory compliance, care transitions, and resident satisfaction.

Essential Duties and Responsibilities:

Coordinate and monitor resident care plans in collaboration with the interdisciplinary team.

Facilitate communication among physicians, nursing staff, therapists, residents, and family members.

Participate in care plan meetings and ensure resident-centered care goals are established and updated.

Monitor resident progress and identify barriers to achieving care goals.

Discharge Planning

Develop and implement safe and effective discharge plans.

Coordinate post-discharge services, including home health, hospice, durable medical equipment, transportation, and community resources.

Educate residents and families regarding discharge needs and available resources.

Ensure timely and accurate discharge documentation.

Utilization and Insurance Management

Assist with insurance authorizations and continued stay reviews.

Communicate with managed care organizations and third-party payers regarding resident status and coverage.

Monitor length of stay and assist in achieving appropriate reimbursement and utilization goals.

Track and document payer requirements and authorizations.

Resident and Family Support

Regulatory Compliance:

Maintain accurate and timely documentation in accordance with facility policies and state and federal regulations.

Participate in Quality Assurance and Performance Improvement (QAPI) activities.

Assist with survey preparation and compliance initiatives.

Ensure adherence to HIPAA and confidentiality standards.

Interdisciplinary Team Collaboration

Attend daily clinical meetings, utilization review meetings, and care conferences.

Collaborate with rehabilitation, nursing, dietary, social services, and medical staff to optimize resident outcomes.

Identify opportunities to improve care coordination and reduce avoidable rehospitalizations.

Physical Requirements:

Ability to sit, stand, walk, and move throughout the facility.

Ability to communicate effectively with residents, families, staff, and external agencies.

Ability to lift and carry up to 25 pounds occasionally.