Care Management Assistant - ED Navigation

About the role

The Care Management Assistant is a patient-focused role that manages and optimizes patient care in collaboration with nurses and social work care managers, often serving as a bridge between patients, their support people, and the healthcare team.

Responsibilities

• Serves as a liaison between the department and external organizations or individuals, including payers, physicians, post-acute agencies, patients, patient, patient representatives, and other departmental stakeholders.
• Receives and prioritizes requests and transmits clinical information for service authorizations in accordance with contractual requirements and communicates with care managers, utilization review RNs, revenue cycle, and payers as needed to coordinate processes and research payment sources.
• Maintains ongoing communication regarding the status of referrals and updates the status of referrals.
• Requests and retrieves medical records from Health Information Management for retrospective utilization review or quality assurance.
• Delivers routine regulatory notices to patients within the required timeframes, ensuring proper documentation to support the delivery of government-mandated forms or payer communication.
• Performs clerical tasks to support care management services, including preparing and printing reports, scheduling appointments, distributing and communicating requests, retrieving message (phone, fax, email, and mail), and scanning or copying documents as needed.
• Supports advanced care planning by delivering advance directive information and notarizing documents upon request.
• Aids in transition planning by preparing transfer packets, arranging transportation, updating resources on the Integrated Care Management website, and coordinating with patients, families, and next-level providers.
• Collaborates with care managers to navigate and refer patients to community resources that address social determinants of health.
• Works closely with care managers and clinical teams to ensure patients receive comprehensive and coordinated care.
• Contributes, in collaboration with Care Management, to the monitoring and success of patient care plans and the resolution of identified social needs.

Requirements

• Demonstrated healthcare experience in a clinic or hospital setting.
• Demonstrated customer service with a focus on communications and problem resolution.
• Proficiency in advanced computer skills.
• Caregivers whose duties require them to conduct home or community visits must maintain current BLS certification, have a current driver’s license, current auto insurance, an acceptable driving record and reliable transportation.

Qualifications

• Demonstrated healthcare experience in a clinic or hospital setting.
• Demonstrated customer service with a focus on communications and problem resolution.
• Proficiency in advanced computer skills.
• Caregivers whose duties require them to conduct home or community visits must maintain current BLS certification, have a current driver’s license, current auto insurance, an acceptable driving record and reliable transportation.

Skills

• Referral Management
• Patient Advocacy
• Care Coordination
• Communication
• Prioritization
• Compliance
• Documentation
• Organization
• Problem Solving
• Community Resource Navigation
• Electronic Medical Record Documentation

Benefits

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn More About Our Comprehensive Benefits Package Here.

Pay

Actual hourly rate dependent upon experience. $20.07 - $28.59

Schedule

Scheduled Weekly Hours 0