Sr Care Management Assistant

About the position

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve. Under the supervision of the Manager, Case Mgr Behavioral Health the Sr Care Management Asst will provides administrative support to the clinical Case Management team. Responsibilities include triage of Customer Segment Task list, outreach to members.

Responsibilities

• Reviews and processes case and condition management referrals from Customer Segment task lists per guidelines.
• Review task note and members' discharge status to prioritize work schedule.
• Check members' eligibility and demographic information.
• Outreach call to members following Case Management guidelines.
• Appropriate and thorough documentation of referral and calls in medical management system utilizing standard documentation.
• Introduce case management program and upon acceptance, schedule appointment at members' convenience or warm transfer to a registered nurse case manager.
• If immediate need or crisis identified, transfer to clinical designee (Sr. CMA MUST REMAIN ON LINE TO ANNOUNCE CALL).
• If call is unsuccessful, follow the appropriate failure to contact process and generate letter.
• If appointment is scheduled, add appointment time to case manager's outlook calendar and generate a task per guidelines.
• If warm transfer, transfer member to case manager and generate a task per guidelines.
• When unable to reach member, or member declines, document in medical management system as per guidelines.
• Documentation is in compliance with NCQA guidelines.
• Develop tickler list for next business day, which includes any unfinished tasks.
• Complete weekly and monthly stats.
• Functions as Preceptor to new Care Management Assistants.
• Retrieves and processes voice mails and external case management referrals per guidelines.
• Other duties as assigned.

Requirements

• High school diploma, degree preferred.
• Computer skills required.
• Prior experience as CMA or Precertification Specialist position preferred.
• Ability to learn quickly, think logically, and possess a problem-solving aptitude.
• Understanding of the relationship between the IBC Family of Companies and Managed Care Programs.
• Attention to detail and accuracy is crucial.
• Excellent customer service skills including an understanding of medical terminology.