Case Managment Specialist II, Care Coordinator, Per Diem, Days

MarinHealth•Greenbrae, CA

1d•$30 - $45

About The Position

Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team, an affiliation with UCSF Health, an ever-expanding network of clinics, and a new state-of-the-art hospital, MarinHealth is growing quickly. MarinHealth comprises MarinHealth Medical Center, a 327-bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties. We attract healthcare’s most talented trailblazers who appreciate having the best of both worlds: the pioneering medicine of an academic medical center combined with an independent hospital's personalized, caring touch. MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others. Job Description Summary: The case management specialist is responsible for providing technical, administrative and clerical support to the case management department. The CM specialist acts independently with oversight of the case manager to facilitate appropriate patient placement, and to implement the discharge plan developed by the case manager.

Requirements

A.A degree in Business /Health Related field or equivalent experience in a health care setting required
Proficiency in medical terminology
Experience in utilization review or discharge planning, financial counseling or registration
Minimum of 2 years of job related experience in a health care setting
Proficiency with electronic health record (EHR) and other case management applications i.e. MIDAS
Integrative Agitation Management (IAM) Required within 30 days of hire
Knowledge of available health care and community resources appropriate to the population served
Knowledge of alternative levels of care including criteria required for payment and application processes
Knowledge of transportation criteria
Ability to carry out instruction provided in written or oral
Ability to manage , set priorities and operate with minimal direct supervision and can work effectively under pressure

Responsibilities

Supports the utilization management process by entering requests for utilization review, authorization of stay for concurrent and post billing denials to support case management workflow.
Collaborates with case manager and social work staff as requested to provide post acute referrals for discharge needs.
Executes the discharge plan developed by the care coordination team by initiating timely referrals to other services and facilities as necessary under the supervision of the case manager/social worker.
Verifies benefits and prior authorization requirements from insurers and documents findings in the electronic medical record.
Presents community resource lists and postacute care vendor lists as directed by the case manager.
Independently and proactively initiates follow-up with post acute referral setting to ensure timely discharge.
Provides the Second IM letter to Medicare patients prior to discharge and documents in the medical record.
Documents accurately, thoroughly, and legibly in the medical record.
Demonstrates proficiency in use and application of all electronic applications.
Makes patient transportation arrangement as necessary insuring proper authorization from insurance source.
Answers multiple and /or designated telephone lines, able to prioritize and route calls
Prepares denial letters as indicated per department policy and regulatory guidelines.
Provides clerical support as needed including copying, faxing and data entry.
Collaborates with team members on interdependent tasks.
Demonstrates both initiative and flexibility working with Physicians, Case Managers and other staff.
Ensures that routine and priority tasks are completed within established departmental time frames.
Positively contributes to team decision making process in planning daily priorities, resolving barriers to discharge plans seeking creative solutions.