Discharge Assistant - Care Management - Flex - Weekends

Carilion Medical Center•Roanoke, VA

3d•Onsite

About The Position

This is Carilion Clinic ... An organization where innovation happens, collaboration is expected, and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious. Headquartered in Roanoke, Va., you will find a robust system of award-winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute. Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life are good. Make your tomorrow with us. The Throughput/Discharge Assistant assists with providing efficient, quality and cost-effective throughput/discharge services at Carilion Clinic Health System. Provides other assistance to the team within Care Management as needed. Schedules peer-to-peer (P2P) conversations between Carilion providers and payor liaisons, gathers required clinical and demographic data for UM/Appeals cases and disseminates to appropriate recipients, supplies payor information to UM team and documents actions taken. The Discharge Assistant provides direct support to the Social Work and Case Manager roles within Care Management to assure efficient, quality and cost effective services. Serves as a support resource at the direction of Social Work and Nurse Case Manager staff on the medical units and facilities. Resolves concerns including research and resolution of issues and requests ensuring a timely turnaround to facilitate throughput. Prioritizes and performs clerical duties to maintain workflow functions as primary responsibility or back up and as applicable to the department. Regulatory tasks that are federally mandated such as the Medicare Important Message letter delivery and the UAI long term care Medicaid approval process. Delivery of in person letters to patients (Medicare Important Rights, observation to IP and Code 44 etc.). Process health plan specific referral requirements including prior authorizations, and assisting with denial resolutions as well as peer to peer initiations related to post-acute and throughput needs. Will be a resource/liaison with regard to payers, billing, staff, patients and providers. Field phone calls re: pricing, benefits, coverage, information about programs and insurance questions. Facilitates timely collection of paperwork, signatures, and other correspondence from the Care team and external agencies required to facilitate a timely discharge. Ability to travel between units, care areas, and floors of a medical facility to facilitate throughput needs

Requirements

Education: Associate degree or 2 years of experience can be considered in lieu of degree.
Experience: 2 years of experience in data collection and analysis and/or advanced administrative support required.
Licensure, certification, and/or registration: Virginia MLTSS (UAI) Certification required.
Advanced computer skills with knowledge of a variety of software programs, including Microsoft word, Excel, Access, word processing, spreadsheets and presentation or database software.
Excellent communications and organizational skills required.

Responsibilities

Assists with providing efficient, quality and cost-effective throughput/discharge services
Provides other assistance to the team within Care Management as needed
Schedules peer-to-peer (P2P) conversations between Carilion providers and payor liaisons
Gathers required clinical and demographic data for UM/Appeals cases and disseminates to appropriate recipients
Supplies payor information to UM team and documents actions taken
Provides direct support to the Social Work and Case Manager roles within Care Management to assure efficient, quality and cost effective services
Serves as a support resource at the direction of Social Work and Nurse Case Manager staff on the medical units and facilities
Resolves concerns including research and resolution of issues and requests ensuring a timely turnaround to facilitate throughput
Prioritizes and performs clerical duties to maintain workflow functions as primary responsibility or back up and as applicable to the department
Regulatory tasks that are federally mandated such as the Medicare Important Message letter delivery and the UAI long term care Medicaid approval process
Delivery of in person letters to patients (Medicare Important Rights, observation to IP and Code 44 etc.)
Process health plan specific referral requirements including prior authorizations, and assisting with denial resolutions as well as peer to peer initiations related to post-acute and throughput needs
Will be a resource/liaison with regard to payers, billing, staff, patients and providers
Field phone calls re: pricing, benefits, coverage, information about programs and insurance questions
Facilitates timely collection of paperwork, signatures, and other correspondence from the Care team and external agencies required to facilitate a timely discharge
Ability to travel between units, care areas, and floors of a medical facility to facilitate throughput needs