Care Management Assistant

Hours

Full-Time: 80 Hours/Biweekly

7:30am - 4:00pm

General Summary

Performs a variety of duties related to facilitating the discharge planning process. Assists the Care Management team with the clerical functions. All tasks listed below may be expected in assigned daily work.

Duties and Responsibilities

Essential Functions:

• Assists with clerical functions (e.g., filing, copying, scanning, emailing, telephone, taking minutes)
• Determines patient health insurance benefit information as requested by CMRN/CMSW.
• Reviews payor logs and enters authorization information into EMR/patient record.
• Receives denial information and records in EMR/patient record; forwarding same to assigned CMRN.
• Initiates SNF authorizations as requested by CMSW/CMRN; followed by documentation of payor determination in EMR/patient record.
• Completes discharge notification to varied insurance payors.
• Assists CM team with IMM notices to patient.
• Assists with medication pricing as requested by CMRN/CMSW.
• Coordinates after care issues with the appropriate team members.
• Supports the CM team by coordinating follow up PCP appointments.
• Compiles data for and prepares regularly scheduled or special reports, analysis, and statements.
• Reviews daily patient discharge list, routes incomplete VNA orders, identifies incomplete auth information, reviews final disposition Epic navigator for accuracy and completeness.
• Works and maintains Incomplete Auth work queue; obtains delinquent authorizations and records in EMR.

Common Expectations:

• Maintains Downtime computer terminal/ associated logs.
• Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 2 years Relevant experience. Required

Licenses:

• Basic Life Support Upon Hire Required

Knowledge, Skills, and Abilities:

• Basic computer skills.
• Telephone etiquette.
• Good communication skills.
• Medical terminology preferred.