Care Management Assistant: Irvine Care Management
About The Position
Under the supervision of the Supervisor, the Care Management Assistant performs essential duties supporting Care Management for Hoag Hospital and its affiliates. The 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 Care Management Assistant interacts with representatives from insurance companies, health maintenance organizations, home care agencies, skilled nursing facilities, durable medical equipment companies, and transportation agencies. The role collects and audits patient outcome data, prepares utilization review reports, documents activities and progress in medical charts and computer billing/utilization systems, inputs clinical information into database systems, and prepares Medical Appeal paperwork. The assistant demonstrates a work style reflecting the mission, vision, and values of the Care Management team and the Organization, participates in continuous quality improvement, and maintains working knowledge of departmental standard operating procedures, including specialized instrumentation, quality control requirements, and preventive maintenance.
Requirements
- One year of acute care, home health, or skilled nursing facility experience required.
Nice To Haves
- Two years of college-level education in healthcare or a related field.
- Working knowledge of Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint, and healthcare database systems.
- Bachelor’s degree in a healthcare-related field.
- Three years of administrative experience working in a healthcare environment.
Responsibilities
- Implement patient discharge plans.
- Assist with coordination of clinical utilization review.
- Make third-party payer notifications in support of nursing and social work staff on the case management team.
- Interact with representatives from insurance companies, health maintenance organizations, home care agencies, skilled nursing facilities, durable medical equipment companies, and transportation agencies.
- Collect and audit patient outcome data.
- Prepare reports for utilization reviews.
- Document activities and progress in medical charts and computer billing/utilization systems.
- Input clinical information into database systems.
- Prepare Medical Appeal paperwork.
- Participate in the continuous quality improvement process.
- Maintain working knowledge of departmental standard operating procedures, including specialized instrumentation, quality control requirements, and preventive maintenance.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
