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Regional Case Manager

Eastern Healthcare Group • Clifton, NJ, US • published 2026-09-24 22:03:54.957691

Description

**Regional Case Manager** **Summary:** The Case Management plays a critical role in centralizing and coordinating insurance authorization and case management functions across our multi\-facility skilled nursing and long\-term care network in Virginia. This position ensures timely authorization and continuation of care for residents under Medicare, Managed Care, Medicaid Managed Care, and commercial insurance plans. Working from our corporate office, the Case Management serves as a liaison between facility clinical teams, payers, and external partners to optimize reimbursement, reduce denials, and ensure compliance with payer requirements and CMS regulations. **Essential Duties \& Responsibilities:** * Coordinate and obtain insurance authorizations for admissions, continued stays, and skilled service requests for all managed care and commercial payers. * Serve as the primary contact between facility case managers, billing teams, and insurance representatives. * Review clinical documentation to support medical necessity and communicate payer requirements to facility teams. * Track and monitor authorization requests, approvals, and expirations to prevent lapses in coverage. * Maintain...

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