Care Management Assistant

Cottage Health•Santa Barbara, CA

12d

About The Position

The Care Management Assistant (CMA) primary focus is on assisting the Care Management staff and their patients with Social Work, Case Management, and Discharge Planning. Responsible for assisting with performing care coordination, resource linkage, program development, utilization review, clerical work, and discharge planning for Cottage Health patients. The CMA's activities will result in quality outcomes, optimal care/cost management of services and/or procedures, a high level of customer satisfaction, and contribution to an overall value-oriented experience of stakeholders and persons served. Provides guidance and assistance with patients in need of charity, benefits, and Medi-Cal related needs. Responsibilities This is not an exhaustive statement of duties, responsibilities, or requirements. Employees will be required to perform any job, with related instruction given by their supervisor, subject to reasonable accommodation. Resource Linkage:? Link patients to internal and external resources as appropriate? Identify and provide follow up DCIM letters to appropriate patients for all hospital inpatient units? Provide resources to help with social and medical issues? Assist patients with access to charity, financial, insurance, benefits, and disability assistance? Arrange and coordinate presentations by outside entities that can be of assistance to patients and staff members? Maintain stock of commonly used unit resources such as EDD forms, Senior Resource Directories, bus tokens, Clean Air Express Vouchers, Taxi Vouchers, etc.? Assist Case Managers and/or Social Workers with establishing availability of patient placements at alternate level of care facilities? Maintain communication with representatives of community alternate level of care facilities? Help facilitate patient transfers to the new placements (40%) Utilization Review:? Assess patients' insurance coverage for meeting criteria for services needed, including admission to the hospital? Assess patients for meeting criteria and having insurance coverage or private pay funds for recommended transfers to outside facilities and services? Review patient services to assess if adequate access to these services when available and refer to Care Management team when appropriate? Verify insurance coverage and work with the Patient Access Department to ensure all insurances are known and valid? Assess patients' eligibility for additional insurance coverage requests by Care Management staff members and assist as needed with the application process? Maintain timely and accurate records in the medical chart? Arrange and/or assist with referrals for home care services as determined by the Case Manager or Medical Social Worker (20%) Utilization Review:? Assess patients' insurance coverage for meeting criteria for services needed, including admission to the hospital? Assess patients for meeting criteria and having insurance coverage or private pay funds for recommended transfers to outside facilities and services? Review patient services to assess if adequate access to these services when available and refer to Care Management team when appropriate? Verify insurance coverage and work with the Patient Access Department to ensure all insurances are known and valid? Assess patients' eligibility for additional insurance coverage requests by Care Management staff members and assist as needed with the application process? Maintain timely and accurate records in the medical chart? Arrange and/or assist with referrals for home care services as determined by the Case Manager or Medical Social Worker (40%) Qualifications All job qualifications listed indicate the minimum level necessary to perform this job proficiently.

Requirements

Basic office software skills, i.e. MS Word, Excel.
Skilled at negotiating, persuading, problem solving, and multi-tasking.
Ability to be flexible, dependable, work independently, be self directing, and have tolerance for stressful situations.
Ability to effectively read, write and speak in English.
Must have common sense, adaptability, ability to manage and institute change, organizational skills, a strong desire to promote team spirit, assertiveness, and the ability to be diplomatic and culturally sensitive.

Nice To Haves

Associate's Degree.
Intermediate typing and office software skills.
Bilingual: Spanish speaking, reading and writing.
Bilingual Spanish speaking, reading and writing skills are strongly desired.

Responsibilities

Link patients to internal and external resources as appropriate
Identify and provide follow up DCIM letters to appropriate patients for all hospital inpatient units
Provide resources to help with social and medical issues
Assist patients with access to charity, financial, insurance, benefits, and disability assistance
Arrange and coordinate presentations by outside entities that can be of assistance to patients and staff members
Maintain stock of commonly used unit resources such as EDD forms, Senior Resource Directories, bus tokens, Clean Air Express Vouchers, Taxi Vouchers, etc.
Assist Case Managers and/or Social Workers with establishing availability of patient placements at alternate level of care facilities
Maintain communication with representatives of community alternate level of care facilities
Help facilitate patient transfers to the new placements
Assess patients' insurance coverage for meeting criteria for services needed, including admission to the hospital
Assess patients for meeting criteria and having insurance coverage or private pay funds for recommended transfers to outside facilities and services
Review patient services to assess if adequate access to these services when available and refer to Care Management team when appropriate
Verify insurance coverage and work with the Patient Access Department to ensure all insurances are known and valid
Assess patients' eligibility for additional insurance coverage requests by Care Management staff members and assist as needed with the application process
Maintain timely and accurate records in the medical chart
Arrange and/or assist with referrals for home care services as determined by the Case Manager or Medical Social Worker