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Case Management Assistant- CMH Care Facil and Util Mgt

Carle

Carle

Peoria, IL, USA
Posted on Wednesday, July 10, 2024


Job Description

JOB SUMMARY:
The Case Assistant works under the direction of the Clinical Transition Specialist (RN Case Manager) and/or Social Worker to establish appropriate discharge plans for patients such as but not limited to making referrals, identifying transportation needs and making arrangements, and completing authorization requests for medications or placement.

Responsible for supporting federal and state regulatory compliance through the distribution and documentation for the Important message for Medicare, the MOON and observation notices. Responsible for supporting readmission strategies through identification of patients needing a new primary care provider, and/or making appropriate post-acute follow up plans with primary care and specialty physician practices.

Has a strong customer service focus as will interact with patients, families, and providers. Conveys a positive image of Carle and provides information to patients to fully utilize and benefit from Carle services both on the telephone and face-to-face and to ensure that needs of patients are met.

EXPERIENCE REQUIREMENTS
Three (3) or more years in customer service focused role, perferably in a health care setting, or Two (2) years or more of CNA experience.

SKILLS AND KNOWLEDGE
Good problem-solving skills, self-directed, and able to complete required assigned work independently.
Effective interpersonal and communication skills with individuals in diverse professional and patient groups.
Possesses knowledge and skills to work effectively with patients and their families including neonate, children, adolescents, adults and the elderly.
Must have strong communications skills and work well with all employees and the public at large; observes high standard of confidentiality. Must maintain positive attitude when working.
Ability to deal with a large volume of calls and multiple tasks concurrently; memory for details essential.
Must be able to prioritize and complete tasks under stressful conditions with interruptions.
Ability to accept and implement change and function in instances where decisions are not always apparent.
Required to apply routine decisions to defined problems.
Responsible for selecting courses of action that have substantial effect on customer satisfaction and revenues, where decisions are guided by general policy or at the request of liscensed personnel; required to deal with issues of a complex nature, requiring good judgment.
Must be self-motivated and dependable.
Must have the ability to type, organize and manage detailed data with attention to detail.
Ability to acquire good working knowledge of program-specific computer applications.

ESSENTIAL FUNCTIONS:
  • Collaborates with the RN Case Manager and SW Case Manager to develop a plan of care for discharging the patient.
  • Assists with nursing home placement to ensure a smooth transition for the patient, including: placing referrals, updated referrals, and answering incoming calls from the nursing facilities
  • Responsible for maintaining Medicare regulatory compliance with the delivery of the "Important Message" documents.
  • Performs or assists case managers and/or social workers with daily tasks. This may include assisting in arranging transportation and/or transport and other necessary tasks.
  • Schedule specialty and primary care post discharge appointments.
  • Coordinate external primary and specialty services in and out of network.
  • Communicates post discharge directives, appointments and necessary information.
  • Documents assistance in Case Management system and Epic.
  • Collects data on assigned patients and help to ensure accurate documentation
  • Provides routine office and clerical support to department staff, as appropriately delegated.
  • Obtain prior authorization as needed.
  • Acts as liasion for ED providers and Hospitalists for ancillary services.
  • Demonstrates knowledge of Medicare and MOON letter guidelines, and delivers the letters based on the timelines outlined.



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