UM Care Management Coordinator

Corewell HealthSt Joseph, MI
Onsite

About The Position

Ensures that timely, accurate and complete data is submitted to appropriate insurance companies to guarantee prompt payments to Corewell Health. Communicates and collaborates with the multidisciplinary team through verbal and written communication. Participates with Care Team for the integration of the patient to the home or transitional environment by developing, planning, implementing and evaluating in accordance with current existing federal, state and local standards. Adheres to confidentiality policies specific to communications, patient confidentiality, record keeping and coordination services.

Requirements

  • High School Diploma or equivalent
  • 2 years of relevant experience
  • Related work in a clinical office or health insurance setting
  • Working in an organization of size and complexity comparable to Spectrum Health

Nice To Haves

  • Associate’s degree Business Administration, Management, Commerce, Communications, Public Relations or other related degree or equivalent combination of education and experience

Responsibilities

  • Inputs data from various sources (insurance companies, admissions, certification, and other hospitals) into Care Management discharge planning software and insures communication to members of Care Team.
  • Processes and prepares clinical reviews completed by Care Management Department (CMD) employees for confidential transmission to third party payers.
  • Maintains ongoing communication between Corewell Health (CH) and third party payers related to the number of hospital days authorized, additional requests for clinical information, anticipated discharge needs, etc.
  • Supports specific third party payers by obtaining authorization for services; providing accurate & timely admission/discharge dates; updating CMD and SH employees on any demographic changes; problem solving issues/concerns third party payer may have.
  • Reports reviews needed to case manager.

Benefits

  • Comprehensive benefits package to meet your financial, health, and work/life balance goals.
  • On-demand pay program powered by Payactiv
  • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
  • Optional identity theft protection, home and auto insurance
  • Traditional and Roth retirement options with service contribution and match savings
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