Care Management Resource Center Specialist
About The Position
Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world. The Care Management Resource Center receives and appropriately addresses all requests from the TCC/SW to ensure transitions of care are facilitated in a timely manner. As a Center Specialist, your responsibilities often include initiating the post-acute pre-certification process with facilities and insurance companies, making referrals to post-acute agencies and documenting the details of the discharge transition plan. This is a remote role after training with on-site requirements occurring once per month. A caregiver in this position works from 9:00am to 5:30pm.
Requirements
- High School Diploma or GED
- Three to five years of current administrative/clerical experience working in healthcare or a related field
- Fluency in medical terminology
- Computer literacy
- Excellent verbal and written communication and organization skills
- Must reside in Northeast Ohio
Responsibilities
- Support the Transitional Care Coordinator and Inpatient Social Worker with specified non-clinical work.
- Initiate contact with payers to facilitate precertification for transfer to post-acute facilities, provide clinical documentation and ensure timely follow up calls.
- Initiate contact with post-acute agencies, provide updates as requested and facilitate placement.
- Facilitate 7000 forms by Healthcare Electronic Notification System (HENS).
- Place and close referrals in AllScripts Care Management.
- Handle calls from commercial payor case managers with questions regarding admitted patient’s discharge plans.
- Manage post-acute pre-cert process for commercial insurance patients needing pre-cert to post-acute facilities.
- Provide necessary verbal and electronic communication to and from care management staff, serving as a liaison between hospital personnel and the various agencies.
- Serve as a central hub communicator for discharge plan information.
- Completes data tracking and collection to assist with the identification of routine statistics and problems or trends.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
