Care Management Assistant - UMC

LCMC Health • New Orleans, LA

6d

About The Position

The Care Management Assistant supports the care management team with utilization review activities, including intake, transmission, and tracking of clinical reviews to payors. The role coordinates post-hospital care and service arrangements and helps ensure that the documentation, communication, and information needed to facilitate patient discharge are complete. This work supports patients as they transition to the next phase of their healthcare journey.

Based at University Medical Center, the position also supports discharge planning, post-acute referrals, payer communications, denial and appeal processes, and department data management. The job description notes that the listed responsibilities describe the general nature of the work and are not exhaustive.

Requirements

• A combination of appropriate education and work experience.
• High school diploma or GED and two years of office or clerical experience in a healthcare setting.
• Four years of experience in a healthcare setting may be substituted for the education requirement.

Responsibilities

• Participate in discharge planning activities as needed to support appropriate post-acute referrals and timely patient discharges.
• Research available preferred post-acute providers to meet patients’ discharge needs.
• Contact post-acute care providers, transmit referral information, and follow up to identify and communicate available resources.
• Collect, copy, and transmit patient demographic and clinical information needed for post-acute care arrangements or placement.
• Transmit transition-of-care documents to primary care physicians and post-acute providers.
• Coordinate with the case management team to facilitate timely transmission of utilization reviews to payers.
• Communicate pertinent information received from payers to relevant stakeholders.
• Support concurrent insurance denials and appeals processes and share denial and non-certified-day information with appropriate stakeholders to reduce potential denials.
• Collaborate with other departments to ensure patient and payer information is accurate.
• Assist department leadership with data management.
• Maintain accurate payer contact information and update it in the software system to support accurate review submissions.
• Validate and update vendor information.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED