Care Management Assistant : Care Management

Job Description 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.

Qualifications 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

License Preferred Licensed Clinical Social Worker (LCSW) in good standing with the State of California

About Us Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ .

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.