Case Manager Extender- TGH Care Coordination

Tampa General Hospital•Tampa, FL

About The Position

The Case Management Extender (CME) is a patient-facing care coordination role that provides advanced operational, regulatory, and post-acute coordination support to the Case Management department. The primary function of this CME group is to decrease avoidable bed days and length of stay while ensuring safe, effective transitions of care across the continuum and beyond discharge. This role operationalizes Case Manager–identified discharge plans by coordinating post-acute services, appointments, transportation, and payer-aligned resources, allowing Case Managers to remain focused on bedside clinical assessment and planning. The CME ensures regulatory notice delivery in compliance with the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs) and serves as a subject matter expert in payer resources and post-acute network navigation to support successful community-based care plans.

Requirements

High School Diploma or GED
Experience in a hospital, clinical office, or insurance environment, with demonstrated knowledge of community-based resources and payer systems to support safe and effective patient outcomes.
Proficiency in medical terminology is required.
Candidates must demonstrate computer literacy, including experience with internet-based applications, Microsoft Office, and clinical electronic medical record (EMR) systems.
Strong multitasking, prioritization, and attention to detail
Strong analytical and communication skills with the ability to read, interpret, and convey complex information effectively.
Expertise in post-acute care coordination, payer networks, and community-based resources
Demonstrated knowledge of CMS Conditions of Participation (CoP) related to regulatory notice delivery
Demonstrated knowledge of Florida Agency for Health Care Administration (AHCA) related to regulatory notice delivery and guidelines.
Professional communication with patients, families, vendors, and interdisciplinary teams
Operationalize Case Manager–identified discharge plans by coordinating post-acute services, appointments, and resources needed to achieve timely, safe discharge
Actively support reduction of length of stay and avoidable bed days by mitigating non-clinical discharge barriers, enabling Case Managers to remain at the bedside
Commitment to Tampa General Hospital values and patient-centered care
Ability to self-manage, prioritize multiple tasks, and adapt to changing priorities in a fast-paced environment.

Nice To Haves

Epic (clinical documentation, CME requests, task lists) and all affiliated EMR tools utilized by TGH
Payer portals, OnBase, RightFax, Availity, Accentra, Wellsky(as applicable to post-acute coordination)
Microsoft Outlook, Teams, Excel for communication and tracking
Departmental task boards and post-acute tracking tools
Participates in department education, workflow improvement, and cross-training initiatives

Responsibilities

Deliver, document, and track MOON/HOON and other regulatory notices in a manner that ensures ongoing compliance with CMS CoP and AHCA and applicable regulatory standards
Provide real-time communication and follow-up with Case Managers, Social Work, patients, families, and interdisciplinary teams
Document all interventions clearly and timely in Epic and related systems
Identify, secure, and coordinate cost-effective, in-network post-acute providers and services (e.g., home health, DME, SNF, LTACH, specialty services) based on Case Manager assessments
Work directly with outside vendors, facilities, and community providers to obtain service acceptance and confirm readiness for discharge
Verify payer network status, benefit coverage, and post-acute authorization progress to support timely transitions of care
Ensure post-acute plans align with payer requirements, clinical needs, and safe discharge criteria
Support patients and families by communicating appointment details, service expectations, and next steps as delegated
Schedule post-discharge and post-acute appointments (specialty care, follow-up visits, procedures, services) as delegated
Coordinate scheduling logistics to align with discharge readiness and post-acute service availability
Document appointments, confirmations, and barriers in the medical record or designated tracking tools
Obtain and coordinate multi-level transportation arrangements, including basic, ALS, critical care, bariatric, and ground or air transport as required
Request and compare transportation quotes to support cost-effective, payer-aligned discharge planning
Coordinate payer-authorized transportation and communicate logistics to patients, families, and care teams
Maintain stewardship of TGH SWAT budget with respect to through review of pt CM/SW assessments, demographic input, and knowledge of available vendors and timeliness of start of service.
Review for pending authorizations for post acute services and manage timeliness of process for efficient transition rom acute care setting by working with community partners and vendors.
Escalates discharge barriers, payer constraints, network limitations, and compliance risks including potential CMS CoP and/or AHCA impacts to leadership
Filing of reports in the event of insufficient care according to CMS and/or AHCA as directed by leadership.