Care Management Assistant - Full Time, Days

About the role

Working under the direction of the RN Care Manager and LCSW, the Care Management Assistant provides assistance in setting up post-hospital care and services. The role supports the completion of care management documentation, communication, and information required to facilitate the discharge process and assists with intake, tracking, and payer reviews.

Responsibilities

• Participates in discharge planning to ensure timely patient discharge and appropriate linkage with post-acute providers.
• Researches and contacts post-acute care providers to transmit referral information and follow up to identify available resources.
• Obtains payor certification for post-acute services and collects, copies, and transmits clinical and patient demographic information for post-discharge arrangements.
• Coordinates transportation, DME, and community services as directed by care managers and social workers.
• Maintains a working knowledge of community agency resources.
• Facilitates timely transmission of reviews to payors and communicates clinical review information via telephone and fax.
• Supports concurrent insurance denials and appeals processes, documents denials by type, payor, and appeal outcome, and provides denial and non-certified day information to Case Managers.
• Collaborates with Patient Access and Patient Financial Services to ensure accuracy of patient and payor information.
• Updates payor contact information and ensures payor and customer satisfaction through effective communication and positive customer service.

Requirements

• High School Diploma or GED.
• Knowledge of medical terminology.
• Computer skills: word processing, spreadsheets, email.
• Excellent interpersonal skills for internal and external communication.
• Excellent organizational and analytical skills to manage multiple tasks simultaneously.
• Ability to work in a team structure and independently with self-direction.
• Strong oral and written communication skills.

Preferred Qualifications

• Some knowledge of contractual reimbursement methodology.
• Some knowledge of insurance agencies and authorization processes.
• Some knowledge of community agencies/resources.
• Healthcare background preferred.
• Hospital experience a plus.

Pay

The salary range for the role is $33,533.27 – $50,000.00 annually. Actual salaries depend on experience, specialty, education, and hospital need. The range does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.