Manager, Post-Acute Access

Job Summary

This leader has accountability and oversight, and supervises the daily activities supporting the post-acute admissions team by establishing a collaborative rapport with key stakeholders. This leader is responsible for managing referrals to SMH post-acute services to ensure a smooth transition of care for patients discharging from a care setting to SMH post-acute services. This role is responsible for all elements of access including compliance with all registration, scheduling, regulatory requirements.

Required Qualifications

• Require a Bachelor's degree in related field; Master's preferred.
• Require a minimum of seven (7) years of clinical practice in a hospital or post-acute setting or relevant work experience in lieu of clinical practice (e.g., registration, billing, insurance processing, auditing) with at least two (2) years within a lead or supervisory role.
• Require the following certifications, which may be obtained within one (1) year of hire: - Certified Healthcare Access Manager (CHAM) certification form the National Association of Healthcare Access Management (NAHAM). - Certified Case Manager (CCM) or Accredited Case Manager (ACM), and Admissions Liaison (UDS).

Preferred Qualifications

• Prefer a minimum of five (5) years of experience with Medicare, Medicaid, insurance, managed care, post-acute guidelines, and patient placement in a post-acute setting.
• Prefer knowledge of PPS payment/reimbursement systems.
• Prefer ability to collect, document, and analyze data.
• Prefer experience in computer skills including spreadsheets, database, word processing, and other common applications.
• Prefer demonstrated leadership skills and understanding of group processes, teamwork, and cost center-based management.
• Prefer demonstrated knowledge of International Classification of Diseases Ninth Revision (ICD-10) coding and Current Procedural Terminology (CPT) coding.
• Prefer demonstrated thorough knowledge of Medicare National Coverage Determination (NCD) and Local Coverage Determination (LCD) protocols for medical necessity/ Advanced Beneficiary Notice.