Case Management Asst./Discharge Planner (Torresdale)

Jefferson Health Plans • Philadelphia, PA

1d • Onsite

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. Discharge Planner works with the Care Management Department. Their role is to complete all post-acute authorizations, set up all transportation, and other duties as assigned. Weekend rotation may be required. Job Description Schedule: M-F 8am-4:30 Campus: Torresdale Essential Functions •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.

Requirements

• Knowledge of the techniques and the ability to work with a variety of individuals and groups in a constructive and collaborative manner.
• Ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation
• High School Diploma – required
• Two years of experience in a health care setting preferred.
• Computer literate, strong knowledge of medical terminology required.

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

• Jefferson offers a 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, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have 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 (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED