Case Management Assistant (Part-Time) - Jefferson Washington Township

Jefferson Health Plans • NJ

88d

About The Position

Works under the direction of the Manager of Case Management and Case Manager RN to provide assistance with the utilization review process, including communicating clinical information/reviews to third party payers to ensure certification/approval of inpatient and post-hospital services. Assists with the coordination of post hospital care and service arrangements. Must be willing to float to all 3 NJ locations. 1 weekend shift commitment every 4 weeks. Major Holiday commitment.

Responsibilities

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Negotiates with payers to obtain authorization for appropriate level of care and length of stay.
• Responsible for meeting insurer timeframes regarding review of clinical information.
• Provides prompt feedback regarding denials and other payer determinations to the Case Manager RN and Physician Advisor.
• Obtain payer authorization and coordinate identified homecare, Durable Medical Equipment (DME), transportation, infusion services and post-acute services for all identified patients.

Benefits

• Comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits.
• Access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time, have access to medical (including prescription) insurance.

What This Job Offers

• Number of Employees: 501-1,000 employees