Care Management Assistant - Full Time, Days- Care Management

NYU Langone Health•Village of Patchogue, NY

6d•$33,533 - $50,000•Onsite

About The Position

Working under the direction of the RN Care Manager and LCSW, the Care Management Assistant helps arrange post-hospital care and services and supports completion of the care management documentation, communication, and information needed to facilitate discharge. The role assists Care Managers with discharge planning, including intake, tracking, and communicating payer reviews. It also provides administrative and case-support functions such as maintaining case files, updating referral information, verifying health insurance or benefits information, and, when needed, interacting with clients, conducting initial intake interviews, supporting discharge plans, and helping review treatment progress. The position supports transition planning and utilization management. Duties include coordinating referrals and post-acute services, obtaining payer certification, transmitting clinical reviews to payors, relaying information between payors and Care Managers, and assisting with denials and appeals. The role collaborates with Patient Access and Patient Financial Services to maintain accurate patient and payor information and communicates with customers and providers to support timely discharge planning.

Requirements

High school diploma or GED.
Knowledge of medical terminology.
Computer skills, including word processing, spreadsheets, and email.
Excellent interpersonal skills to communicate effectively with internal and external customers.
Organizational and analytical skills to manage multiple tasks simultaneously.
Ability to work in a team structure.
Self-directed and able to work independently.
Good oral and written communication skills.

Nice To Haves

Some knowledge of contractual reimbursement methodology.
Some knowledge of insurance agencies and authorization processes.
Knowledge of community agencies and resources.
Healthcare background.
Hospital experience.

Responsibilities

Participate in discharge planning to support timely patient discharge and appropriate linkage with post-acute providers.
Research preferred providers able to meet patients’ post-hospital care needs.
Contact post-acute providers, transmit referral information, and follow up on communication and available resources.
Obtain payor certification for post-acute services.
Collect, copy, and transmit pertinent clinical and patient demographic information for post-discharge care or placement arrangements as directed by Care Managers and social workers.
Coordinate transportation, durable medical equipment, and community services as directed by Care Managers and social workers.
Maintain working knowledge of community agency resources required for the role.
Facilitate timely transmission of reviews to payors in coordination with the care management team.
Communicate initial and concurrent clinical review information from Case Managers to payors by telephone and fax.
Communicate pertinent information received from payors to Care Managers.
Support and assist with concurrent insurance denials and appeals.
Document denials by type, payor, and appeal outcome.
Provide denial and non-certified-day information to Case Managers to help reduce potential denials.
Collaborate with Patient Access and Patient Financial Services to ensure patient and payor information is accurate, and communicate updates promptly.
Support payor and customer satisfaction through effective communication and positive customer service.
Update payor contact information to ensure accuracy.
Perform administrative support tasks such as maintaining case files, updating referral information, and verifying insurance or benefits information.
When required, interact with clients, conduct initial intake interviews, support discharge-plan development with case managers or social workers, and assist with reviewing treatment progress.