Care Management Coordinator
Job Summary
Ensures timely, accurate and complete data is submitted to appropriate insurance companies to guarantee prompt payments to Corewell Health. Communicates and collaborates with the multidisciplinary team through verbal and written communication. Participates with Care Team for the integration of the patient to the home or transitional environment by developing, planning, implementing and evaluating in accordance with current existing federal, state and local standards. Adheres to confidentiality policies specific to communications, patient confidentiality, record keeping and coordination services.
Essential Functions
- Inputs data from various sources (insurance companies, admissions, certification, and other hospitals) into Care Management discharge planning software and insures communication to members of Care Team.
- Processes and prepares clinical reviews completed by Care Management Department (CMD) employees for confidential transmission to third party payers.
- Maintains ongoing communication between Corewell Health (CH) and third-party payers related to the number of hospital days authorized, additional requests for clinical information, anticipated discharge needs, etc.
- Supports specific third-party payers by obtaining authorization for services; providing accurate & timely admission/discharge dates; updating CMD and CH employees on any demographic changes; problem solving issues/concerns third party payer may have.
- Reports reviews needed to case manager.
- Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis.
- Performs other duties as assigned.
Qualifications
- High school diploma or equivalent
- 2 years of relevant experience, related work in a clinical office or health insurance setting
About Corewell Health
As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members, and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.
Primary Location
SITE - Butterworth Hospital - 100 Michigan St NE - Grand Rapids
Department Name
Care Management Acute CMCs CHW - Grand Rapids Hosp
Employment Type
Part time
Shift
Day (United States of America)
Weekly Scheduled Hours
0.04 Hours of Work 8:00 a.m. to 4:30 p.m.
Days Worked
Monday to Friday
Weekend Frequency
Variable weekends