Care Management Resource Center

Cleveland Clinic

1d•Hybrid

About The Position

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. 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
Applicants 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.