About The Position

The Case Management Assistant provides daily support to the Clinical Resource Management (CRM) Department, focusing on quality and utilization data essential for the department's daily operations. This role facilitates the appropriate follow-up in administering Centers for Medicare & Medicaid Services (CMS) forms, such as the Medicare Outpatient Observation Notice (MOONS) and Important Message forms, to enhance the quality of services provided to patients across the system.

Requirements

  • 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.
  • Must be able to lift or carry objects weighing up to 20 pounds.
  • Requires close visual acuity to perform activities such as: extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment.

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.
  • Adheres to professional standards as outlined by protocols, rules and regulations.
  • Develops effective working relationships with the CRM team.
  • Facilitates multiple care aspects as requested by the CRM leadership team for discharge planning (case coordination, information sharing, etc.).
  • Under direction of CRM leadership, assists with daily referrals, per standard protocols, to Primary Care Physician and JHS specialty clinics, scheduling diagnostic studies and other clinic appointments 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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