Case Management Assistant

Position Summary / Career Interest:

The Case Management Assistant works under the direction of the Social Work Manager in Case Management, the Case Management Assistant (CMA) has responsibility to provide care/service safely and efficiently for a full range of services to patients of all ages and their families. The CMA provides support in the operation and communications of the department for the point of entry and inpatient settings. The primary role for the CMA is to collaborate, communicate, and facilitate coordination of services as established by the healthcare team and directed by the Case Manager and Social Worker .

Responsibilities and Essential Job Functions

• Maintain patient, employee, physician and corporate confidentiality; respect the rights, privacy and property of others.
• Communicates timely, relevant and accurate information to the Case Managers and professionals involved with patient’s care; maintains routine communication with case managers on the status of their referral requests; communicate Social Work and Case Management referrals to the assigned staff and notifies the department director/manager when staff is unable to facilitate the referral
• Receives, screens and routes telephone calls and written communications to appropriate staff; returns calls and communicates messages as needed; informs staff members of correspondence requiring immediate attention/action.
• Communicates with payers for verification of benefits on specific patients at the case manager’s request; alerts appropriate staff to adverse determination responses from insurance companies.
• Faxes surgery procedure updates to the Business office staff for Medicaid reimbursement coordination and communication.
• Receives and records new/changed contact information for the sitter’s list.
• Routes contact information from Home Health agencies to appropriate staff to facilitate continuity of care.
• Facilitates the progression of care by obtaining all necessary forms to initiate referrals for the transition of care; distributes post-acute placement requests as directed by the RN, CM and SW; monitors the patient’s progression towards the desired outcome; facilitates certain aspects of the discharge planning, resource referral and patient education
• Participates in RN, CM and SW team planning meetings; integrates the work of the healthcare team by coordinating resources and services requested by the team to assist in accomplishing agreed-upon goals and desired discharge plan. Continuously monitors the patient through frequent interactions with the inpatient team starting at admission through discharge to assist in timely referrals and coordination of post-acute needs
• Ensures data integrity by running reports to validate all data is correctly entered into hospital system
• Demonstrates ability to balance cost and quality to assure optimal clinical and financial outcomes
• Files and maintains insurance communication documents and communication/tracking logs.
• Maintains social work and case management forms and restocks forms as needed
• Completes special projects and/or assignments required to support staff/department operations
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• High School Graduate
• 3 or more years broad administrative/secretarial experience

Preferred Education and Experience

• Associates Degree
• Bachelors Degree
• Healthcare background

Knowledge Requirements

• Some knowledge of contractual reimbursement methodology
• Some knowledge of community agencies/resources
• Must have excellent verbal and written communication skills.
• Strong customer service skills
• Capable of working with multiple tasks simultaneously
• Organizational skills and confidentiality
• MS Office program experience

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.