Care Management Assistant: Care Management

Primary Duties and Responsibilities

• Under the supervision of the Supervisor, the Care Management Assistant performs essential duties to the provision of Care Management for Hoag Hospital and its affiliates (the “Organization”). The Care Management Assistant implements patient discharge plans, assists with coordination of clinical utilization review, and makes third party payer notifications in support of nursing and social work staff on the case management team.
• The Case Management Assistant also interacts with representatives from insurance companies, health maintenance organizations, home care agencies, skilled nursing facilities, durable medical equipment companies, and transportation agencies. Collects and audits patient outcome data, prepares reports for utilization reviews. Documents activities and progress in medical charts and computer billing/utilization systems. Inputs clinical information into database systems. Prepares Medical Appeal paperwork.
• The Care Management Assistant displays and practices a work-style reflecting the mission, vision and values of the Care Management team, as well as the Organization. Participates in the continuous quality improvement process. Maintains a working knowledge of departmental standard operating procedures, including the use of specialized instrumentation, Quality Control requirements, and preventive maintenance.

Education and Experience

• One (1) year acute care, home health or skilled nursing facility experience required.
• Two years of college-level education in healthcare or related field preferred
• Working knowledge of Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint, plus healthcare database systems preferred
• Bachelor’s degree in healthcare-related field preferred
• Three (3) years administrative experience working in a healthcare environment preferred