Integrated Care Management Assistant Case Management

Essential Functions and Responsibilities as Assigned

• Assists with facilitating discharge planning to expedite a successful transition of care.
• Affords support to RN and SW Care Managers with the referral process by collecting and distributing informational brochures/pamphlets that enhance patient/family choice of providers, agencies and other professional health care services.
• Affords coordination post discharge placement and services by making referrals, confirming specific placement and service arrangements, processing, organizing and obtaining insurance verification and/or prior authorization from insurance companies for discharge arrangements.
• Affords contact with community resources to coordinate discharged transition plans while using professional tact and diplomacy skills between patients, colleagues and community.
• Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON) completion.

Requirements

• Associate degree in healthcare-related field
• Two years of clerical experience
• One-year experience in a health care environment utilizing medical terminology or have completed a college level course in medical terminology
• Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN)

Preferred

• Bachelor’s degree in coding/medical records/billing or UM
• Two years of case management or utilization review experience
• Three years of recent experience doing third party payer certification

Benefits

Not specified

Pay

Not specified