About The Position

The Case Management assistant provides daily support to the Clinical resource Management Department in the process of quality and utilization data necessary for the day-to-day operations of the dept. Facilitates appropriate follow up in administering The Centers for Medicare & Medicaid Services forms (Medicare outpatient Observation notices and Important Message forms to enhance the quality of the services being provided to our patients across the system.

Requirements

  • Generally requires 1 to 3 years of related experience.
  • High school diploma is required.
  • Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
  • Ability to communicate effectively in both oral and written form.
  • Ability to handle difficult and stressful situations with critical thinking and professional composure.
  • Ability to understand and follow instructions.
  • Ability to exercise sound and independent judgment.
  • Knowledge and skill in use of job appropriate technology and software applications.
  • Valid license or certification is required as needed, based on the job or specialty.

Responsibilities

  • Provides the Centers for Medicare & Medicaid Services CMS forms (MOONS, IMs) to patients in a safe, timely, and effective manner.
  • Verifies and assures that documentation entered within the patients' medical records are entered accurately and kept confidential.
  • Responds and verifies inquiries from CRM leadership team and/or responsible parties.
  • Interacts with patients to keep track of their progress and to ensure satisfaction.
  • Adhere to professional standards as outlined by protocols, rules and regulations.
  • Develops effective working relationships with CRM team.
  • Facilitates multiple care aspects as requested by CRM leadership team for DC planning (case coordination, information sharing, etc).
  • Under direction of CRM leadership, assist with the daily referrals, per standard protocols, to Primary Care Physician and JHS specialty clinics, scheduling diagnostic studies and other clinics appointment and procedures.
  • Coordinates with outpatient studies as needed.
  • Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
  • Performs all other related job duties as assigned.
  • The incumbent may attend management meetings and may be involved directly or indirectly around confidential management decisions
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