Care Management Assistant : Care Management
About The Position
The Care Management Assistant performs essential duties to the provision of Care Management for Hoag Hospital and its affiliates. This role implements patient discharge plans, assists with coordination of clinical utilization review, and makes third party payer notifications in support of nursing and social work staff on the case management team. The Assistant also interacts with representatives from insurance companies, health maintenance organizations, home care agencies, skilled nursing facilities, durable medical equipment companies, and transportation agencies. Responsibilities include collecting and auditing patient outcome data, preparing reports for utilization reviews, and documenting activities and progress in medical charts and computer billing/utilization systems. The role also involves inputting clinical information into database systems and preparing Medical Appeal paperwork. The Care Management Assistant is expected to display and practice a work-style reflecting the mission, vision, and values of the Care Management team and the Organization. Participation in the continuous quality improvement process and maintaining a working knowledge of departmental standard operating procedures, including the use of specialized instrumentation, Quality Control requirements, and preventive maintenance are also key aspects of the position.
Requirements
- One (1) year acute care, home health or skilled nursing facility experience required
- Two years of college-level education in healthcare or related field preferred
- Working knowledge of Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint, plus healthcare database systems preferred
- Bachelor’s degree in healthcare-related field preferred
- Three (3) years administrative experience working in a healthcare environment preferred
Nice To Haves
- Licensed Clinical Social Worker (LCSW) in good standing with the State of California
Responsibilities
- Implements patient discharge plans
- Assists with coordination of clinical utilization review
- Makes third party payer notifications
- Interacts with representatives from insurance companies, health maintenance organizations, home care agencies, skilled nursing facilities, durable medical equipment companies, and transportation agencies
- Collects and audits patient outcome data
- Prepares reports for utilization reviews
- Documents activities and progress in medical charts and computer billing/utilization systems
- Inputs clinical information into database systems
- Prepares Medical Appeal paperwork
- Displays and practices a work-style reflecting the mission, vision and values of the Care Management team, as well as the Organization
- Participates in the continuous quality improvement process
- Maintains a working knowledge of departmental standard operating procedures, including the use of specialized instrumentation, Quality Control requirements, and preventive maintenance
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What This Job Offers
Career Level
Entry Level
Education Level
Associate degree
