Case Management Associate - Full Time
Case Management Associate - Full Time
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Bachelors of Social Work from an accreditedinstitution preferred.
A minimum of 12 years of clinical and/orcommunity resource experience required.
Reporting to theManager of Case Management and working under the direction of the Case Manager(CM) and Social Work (SW) staff the Case Management Associate provides supportto Case Managers and Clinical Social Workers with routine and regulatory clinicaland administrative functions.
Provides administrative supportrelated to the discharge process through faxing copying and scanning of informationincluding but not limited to referral sources insurers PCP offices; bookingrooms for familyteam meetings; assisting patients with securing new PCPsprior to discharge; researching DME providers.
Supports the process of patientreferral to SNF home care and outpatient. The referral process includesentering clinical information into the 4NEXT referral system and managing thecommunications regarding acceptance and bed offer or denial with facilities; referralsto outpatient via Sharepoint; and contacting home care agencies via telephonewith prereferral information and to establish a start of care date; initiatingthe patient care referral paperwork.
Supports the insuranceauthorization and continued stay process by making initial contact with theinsurance CM to confirm contact information and to establish contacts betweenthe payer and SRH CM; submitting fax and online requests for continued stayauthorization and monitors the decision from the payer.
Researches available communityresources at the request of the CM or SW.
Assists the CM SW patient and/orfamily with applications for community resources such as PT1 handicapplacards and specialized funds.
Maintains a database forinsurancebased processes e.g. denials and appeals Medicaid conversionrequests and decisions.
Contacts patients after dischargeto home to complete the Post Discharge Followup Phone Call process anddocuments the calls per department protocol.
Required Experience:
IC
Employment Type
Full-Time
