Transitions Assistant, Transitions of Care-Northern NJ

Hackensack Meridian Health•Iselin, NJ

1d•Hybrid

About The Position

The Transitions of Care Assistant works closely with Regional Manager, Transitions of Care (TOC) Navigator, physicians and staff in coordinating and communicating gaps in quality care metrics for all TOC patients. They assist with patient navigation and preventative screening compliance. The TOC Assistant works independently to audit clinical data. This promotes workflows that support quality patient care and compliance with documentation and clinical outcome metrics. The TOC Assistant will communicate with the healthcare team to assist patients in transitions of care across the healthcare continuum. The TOC is accountable along with the TOC Navigator to meet clinical quality guidelines and facilitate high quality safe patient care. This position will be based in the Northern Region. (Hackensack Univiersity Medical Center and Palisades Medical Center.) Will also provide support to the Women’s Service team at the network as needed.

Requirements

Associate`s degree or relevant years in healthcare, medical insurance billing, auditing or related field.
Excellent analytical skills.
Good reasoning and problem solving ability.
Highly developed interpersonal skills.
Proficient at multitasking and prioritization.
Ability to work independently as well as in a team environment.
Highly organized.
Good presentation skills.
Demonstrated proficiency with PC and Google Docs skills. Ability to learn and become proficient in electronic medical records and software applications.

Nice To Haves

Registry skills.
Experience with auditing commercial medical insurance payers.
Bilingual preferred.
Experience in a variety of patient settings.

Responsibilities

Audits clinical records for gaps in quality care metrics and follows a corrective plan with guidance from TOC Navigator to facilitate collections and reporting of required quality metrics.
Assist in workflow design that promotes compliance to TOC standards and clinical quality metrics.
Provide weekly reports to TOC Navigator to assist with quality metrics performance that will maximize metrics compliance.
Will work with providers, care coordinators and hospital staff to ensure safe patient transitions.
Accountable for preventative care metric documentation.
Contacts TOC patients to make appointments for outstanding provider follow ups, transportation and discharge phone calls under the direction of the TOC Navigator.
Performs both inpatient and outpatient audits for Managed Medicaid HMO payers. Communicates gaps in quality metrics to Regional Manager and TOC Navigator on a weekly basis.
Assist practice in scheduling appointments and referrals which improves accessibility of office services and patient satisfaction. In addition to the timely transmission of Electronic Health Records to the next level of care provider.
Travel to other assigned HMH hospitals to ensure compliance with TOC policies, procedures and initiatives as directed by the Regional Manager.
Work with management and TOC Navigator to utilize EPIC software to create and report on TOC outcome measures such as ER, inpatient and outpatient quality metric results.
Audit medical records to ensure documentation conforms to TOC standards for inclusion and exclusionary clinical guidelines.
Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
Adheres to the standards identified in the Medical Center's Organizational Competencies.