Case Managment Specialist II, Care Coordinator, Per Diem, Days

About Marinhealth

Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team, an affiliation with UCSF Health, an ever-expanding network of clinics, and a new state-of-the-art hospital, MarinHealth is growing quickly. MarinHealth comprises MarinHealth Medical Center, a 327-bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties. We attract healthcare’s most talented trailblazers who appreciate having the best of both worlds: the pioneering medicine of an academic medical center combined with an independent hospital's personalized, caring touch.

Job Description Summary

The case management specialist is responsible for providing technical, administrative and clerical support to the case management department. The CM specialist acts independently with oversight of the case manager to facilitate appropriate patient placement, and to implement the discharge plan developed by the case manager.

Job Specifications

• Education: A.A degree in Business /Health Related field or equivalent experience in a health care setting required

• Experience: Proficiency in medical terminology,Experience in utilization review or discharge planning, financial counseling or registrationMinimum of 2 years of job related experience in a health care settingProficiency with electronic health record (EHR) and other case management applications i.e. MIDAS

• Licenses and Certifications: Integrative Agitation Management (IAM) Required within 30 days of hire

• Prerequisite Skills: Knowledge of available health care and community resources appropriate to the population servedKnowledge of alternative levels of care including criteria required for payment and application processesKnowledge of transportation criteriaAbility to carry out instruction provided in written or oralAbility to manage , set priorities and operate with minimal direct supervision and can work effectively under pressure

Essential Functions

• Supports the utilization management process by entering requests for utilization review, authorization of stay for concurrent and post billing denials to support case management workflow.

• Collaborates with case manager and social work staff as requested to provide post acute referrals for discharge needs.

• Executes the discharge plan developed by the care coordination team by initiating timely referrals to other services and facilities as necessary under the supervision of the case manager/social worker.

• Verifies benefits and prior authorization requirements from insurers and documents findings in the electronic medical record.

• Independently and proactively initiates follow-up with post acute referral setting to ensure timely discharge.

• Provides the Second IM letter to Medicare patients prior to discharge and documents in the medical record.

• Demonstrates proficiency in use and application of all electronic applications.

• Makes patient transportation arrangement as necessary insuring proper authorization from insurance source.

• Answers multiple and /or designated telephone lines, able to prioritize and route calls.

• Presents community resource lists and postacute care vendor lists as directed by the case manager.

• Documents accurately, thoroughly, and legibly in the medical record.

• Collaborates with team members on interdependent tasks.

• Demonstrates both initiative and flexibility working with Physicians, Case Managers and other staff.

• Sets and prioritizes routine and priority tasks within established departmental time frames.

• Positively contributes to team decision making process in planning daily priorities, resolving barriers to discharge plans seeking creative solutions.

Accommodation

Qualified applicants with disabilities may request reasonable accommodation during the application process by contacting Human Resources at 415-925-7040 or TalentAcquisition@mymarinhealth.org.

C.A.R.E.S. Standards

MarinHealth seeks candidates ready to model our C.A.R.E.S. standards—Communication, Accountability, Respect, Excellence, Safety—which foster a healing, trust-based environment for patients and colleagues.

Compensation

The posted pay range complies with applicable law and reflects what we reasonably expect to pay for this role. Individual pay is set by skills, experience, qualifications, and internal/market equity, consistent with MarinHealth’s compensation philosophy.

Equal Employment

All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sexual orientation, gender identity, protected veteran status or disability status, and any other classifications protected by federal, state, and local laws.