Care Manager Assistant

About the role

This position provides support to the Care Management Team to ensure that the day-to-day operational functions of the department are met in a timely manner. It includes collaboration with third-party payers as well as post-acute providers and is responsible for timely and appropriate documentation within the electronic Care Management System.

Responsibilities

• Greets visitors and health care personnel promptly and professionally; screens visitors and telephone calls to determine urgency of contact and to facilitate appropriate routing or referral; represents Care Management in a positive manner.
• Effectively communicates clinical information with payers to obtain authorization for post-acute services/medications and documents interactions in the patient’s electronic medical record (EMR), along with timely communication with Care Management staff.
• Participates in discharge planning activities (e.g., contacting post-acute care facilities, other community resources, and transportation) as needed to ensure timely patient discharge and appropriate linkage with post-acute providers.
• Provides prompt feedback regarding payer determinations to Supervisor/Care Manager, enabling evaluation or redirection of the current patient plan of care to streamline the delivery of service.
• Functions as placement specialist, as required, including research for preferred providers for HHC/DME/Acute Rehab/SNF/LTACH placement.
• Proactively communicates any change in payer information to Supervisor/Care Manager and documents changes appropriately.
• Verifies with patient financial counseling that all payment sources have been explored and updated in the patient’s electronic medical record (EMR).
• Participates in reimbursement, certification, and authorization-related activities (e.g., faxing or copying required information) as required.
• Contacts and coordinates with referral agencies to arrange provision of ordered equipment and associated services when appropriate, as directed by Care Managers.
• Collects copies and transmits pertinent clinical and patient demographic information required to complete arrangements for post-discharge care and/or placement, as directed by the Care Managers.
• Coordinates and arranges transportation and community services, as directed by Care Managers.
• Provides secretarial and clerical support, including faxing, copying charts, filing, typing, and scanning.
• Ensures payer and customer satisfaction through effective communication and positive customer service skills at all times.
• Maintains confidentiality of communications.
• Uses independent judgment to prioritize appropriately to ensure efficient utilization of time.
• May serve as backup to the Administrative Assistant for Care Management in their absence.

Minimum Qualifications

• High School diploma or equivalent.
• Two (2) years of administrative experience.

Preferred Qualifications

• Associates or advanced degree.
• Two (2) years’ experience in a health care setting.
• Hospital, home health, or payer relations experience.
• Clerical experience in utilization management, discharge planning, or case management.
• One (1) year of ICD-9/CPT Coding or Medical Terminology experience.

Skills and Abilities

• Excellent verbal and written communication skills.
• Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
• Basic computer knowledge and ability to operate standard office software.

Physical Requirements

• Prolonged periods of standing or sitting.

Working Environment

• Flexible hours to include weekends and holidays.
• May include some patient interaction.