Care Management Extender - Adult

About the Role

The Case Management Extender (CME) provides non-licensed, clerical and administrative support to the RN and SW Case Managers to facilitate and execute plan of care and other related case management activities as needed. These positions are available in levels 1, 2, or 3 depending on experience, education, and licenses/certifications.

Responsibilities

• Assists RN/SW Care Manager in arranging care coordination needs.
• Communicates with alternate level of care liaisons to identify an accepting facility and establish a timeline for transfer.
• Arranges and/or assists with referrals for home care services.
• Ascertains resources and assists in making timely arrangements (e.g., transportation, food, lodging).
• Arranges or assists with durable medical equipment needs as determined by hospital policy and physician order.
• Assists in scheduling appointments with providers such as PCP, Therapy, Specialist, and diagnostic testing as needed.
• Maintains patient confidentiality of all communications and documents as required by hospital policy and HIPAA.
• Enters data into multiple systems and submits appropriate information in a timely fashion to facilitate approval and transition of care (e.g., PASRR, medication prior authorizations).
• Issues patient correspondence to ensure compliance with regulatory requirements.
• Responds to inquiries, maintains and revises record keeping and filing systems; classifies, sorts, and files correspondence, articles, records, and other documents.
• Assists Case Manager in submitting PHI clinical information to facilities by fax or submitting clinical data on payer portals.
• Performs other duties as assigned.

Requirements

Minimum Qualifications (Level 1)

• Education: High School Diploma or GED required.
• Experience: 0-3 years of work experience required; 2 or more years of healthcare experience.
• License/Certification/Registration: Basic Life Support from the American Heart Association required.

Minimum Qualifications (Level 2)

• Education: High School Diploma or GED required.
• Experience: 3-5 years of work experience required; 2 or more years of healthcare experience.
• License/Certification/Registration: Basic Life Support from the American Heart Association required.

Skills

• Working knowledge of medical systems and medical terminology or completion of department-approved training within three (3) months of hire.
• Knowledge of CMS regulations, payment systems, post-acute care requirements, or acquisition within 3 months of hire.
• Knowledge of third-party payer issues concerning reimbursement and regulatory parameters or acquisition within 3 months of hire.
• In-depth understanding of typical insurance benefit plans regarding coverage or acquisition within 3 months of hire.
• Proficient with basic computer skills (word processing, Excel spreadsheets, electronic fax).
• Excellent typing skills.
• Ability to work independently, manage time, and prioritize patient needs.
• Able to work some weekends and holidays.
• Able to adapt to frequent changes in direction.
• Excellent interpersonal and communication skills with nursing staff, physicians, nurse practitioners, and other healthcare workers.
• Ability to meet deadlines and manage multiple priorities in complex, fast-paced, and rapidly growing environments.
• Able to work in a dynamic, fast-paced team environment and promote team concepts.
• Excellent verbal and written communication skills.
• Excellent interpersonal skills and ability to maintain composure in difficult situations.

Benefits

We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, creates peace of mind for you and your family.