Care Manager Assistant

Care Manager Assistant

Requirements

• Two years of healthcare experience.
• Advanced computer skills (i.e. developing spreadsheets, creating charts and graphs, word processing, process flows, complex formatting, data manipulation, creating and running reports, creating presentations, and using multimedia content).
• Two years of experience working in an office setting, working in a clerical position with keyboarding and data entry responsibilities, or working in customer service.
• Experience coordinating projects.
• Demonstrated interpersonal verbal and written communication skills including being proficient in spelling, punctuation, grammar, and other English language skills.
• Demonstrated basic math skills.

Responsibilities

• Serves as the primary contact with payers, receiving and prioritizing requests and sending clinical information for authorization of services based on contractual requirements.
• Promptly communicates utilization review needs, days authorized, denials, and other communication from the payers to care managers and physician advisors.
• Collaborates with the revenue cycle staff and others to research payment sources.
• Maintains a current list of contractual requirements and contact information by payer (as communicated by payer contracting). Promptly distributes new information and communicates changes to care management staff and leaders.
• Requests and retrieves medical records from the Health Information Management for retrospective utilization or quality assurance review.
• Delivers routine regulatory notices to patients in the required timeframe (i.e. ‘Follow-Up Important Message from Medicare’ at least one day before the patient’s expected discharge date).
• Performs a variety of specific clerical tasks to support care management services (i.e. prepares and prints reports; prioritizes and schedules appointments; distributes and/or communicates requests; retrieves phone; fax, email, and other messages and/or mail; scans and copies documents as needed).
• Supports advanced care planning by delivering advance directive information and notarizes documents upon request.
• Supports a compliant patient choice process by ensuring online provider lists are current in all systems, distributes provider list to patients/families as instructed, prior to patient choice consult performed by the care manager/social worker.
• Provides support for transition planning (i.e. prepares transfer packets for transition to post-acute/community-based facility or services; ensures resources and documents are routinely updated in the Integrated Care Management website; arranges transportation, confirms arrangements; communicates with the patient/family and next service providers).
• Consistently documents all communication, actions, and information.
• Promptly reports issues and concerns to the departmental chain-of-command.
• Assists with special programs including data collection for process improvement projects.

Preferred Qualifications

• Licensure: LPN; Associate Degree RN; BSW
• College courses related to healthcare, business, and/or or computer/information systems.
• 2 years of experience working in a clinical healthcare setting.
• Medical terminology experience.
• Medical transcription experience.
• Leadership experience (i.e. providing training to others on their job duties, coordinating the work of others, coordinating projects, acting as a team lead, and directly supervising others).