Care Management Assistant (JR24-49820) - West Virginia University Hospitals, Inc.
Morgantown, WV
About the Job
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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. This position includes collaboration with third party payers as well as post-acute providers. This position will also be responsible for timely and appropriate documentation within the electronic Care Management System.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High School diploma or equivalent.
EXPERIENCE:
1. Two (2) years administrative experience.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Associates or advanced degree.
EXPERIENCE:
1. Two (2) years' experience in a health care setting.
2. Hospital, home health, or payer relations experience.
3. Clerical experience in utilization management, discharge planning or case management.
4. One (1) year of ICD9/CPT Coding or Medical Terminology experience.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. 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; representing Care Management in a positive manner.
2.Effectively communicates clinical information with payer to obtain authorization for post-acute services/medications and documents interactions in patient's electronic medical record (EMR) along with timely communication with Care Management staff.
3. Participates in discharge planning activities (e.g. contact of post-acute care facilities, other community resources and transportation) as needed to ensure a timely patient discharge and appropriate linkage with post-acute providers
4. Provides prompt feedback regarding payer determinations to Supervisor/Care Manager, enabling them to evaluate/redirect the current patient plan of care in order to streamline the delivery of service.
5. Function as placement specialist, as required ,to include research for preferred providers for HHC/DME/Acute Rehab/SNF/LTACH placement
6. Proactively communicates any change in payer information to Supervisor/Care Manager and documents changes appropriately
7. Verify with patient financial counseling that all payment sources have been explored and updated in the patient's electronic medical record (EMR).
8. Participates in... For full info follow application link.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
Please view Equal Employment Opportunity Posters provided by OFCCP here.
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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. This position includes collaboration with third party payers as well as post-acute providers. This position will also be responsible for timely and appropriate documentation within the electronic Care Management System.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High School diploma or equivalent.
EXPERIENCE:
1. Two (2) years administrative experience.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Associates or advanced degree.
EXPERIENCE:
1. Two (2) years' experience in a health care setting.
2. Hospital, home health, or payer relations experience.
3. Clerical experience in utilization management, discharge planning or case management.
4. One (1) year of ICD9/CPT Coding or Medical Terminology experience.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. 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; representing Care Management in a positive manner.
2.Effectively communicates clinical information with payer to obtain authorization for post-acute services/medications and documents interactions in patient's electronic medical record (EMR) along with timely communication with Care Management staff.
3. Participates in discharge planning activities (e.g. contact of post-acute care facilities, other community resources and transportation) as needed to ensure a timely patient discharge and appropriate linkage with post-acute providers
4. Provides prompt feedback regarding payer determinations to Supervisor/Care Manager, enabling them to evaluate/redirect the current patient plan of care in order to streamline the delivery of service.
5. Function as placement specialist, as required ,to include research for preferred providers for HHC/DME/Acute Rehab/SNF/LTACH placement
6. Proactively communicates any change in payer information to Supervisor/Care Manager and documents changes appropriately
7. Verify with patient financial counseling that all payment sources have been explored and updated in the patient's electronic medical record (EMR).
8. Participates in... For full info follow application link.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
Please view Equal Employment Opportunity Posters provided by OFCCP here.
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Source : West Virginia University Hospitals, Inc.
