Case Managment Specialist II, Care Coordinator, Per Diem, Days

ABOUT MARINHEALTH
Are you looking for a place where you are empowered to bring innovation to reality Join MarinHealth an integrated independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team an affiliation with UCSF Health an ever-expanding network of clinics and a new state-of-the-art hospital MarinHealth is growing quickly. MarinHealth comprises MarinHealth Medical Center a 327-bed hospital in Greenbrae and 55 primary care and specialty clinics in Marin Sonoma and Napa Counties. We attract healthcares most talented trailblazers who appreciate having the best of both worlds: the pioneering medicine of an academic medical center combined with an independent hospitals personalized caring touch.

MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades including being Named One of the Top 250 Hospitals Nationwide by Healthgrades receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services and being named the Best Hospital in San Francisco/Marin by Bay Area Parent among others.

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Compensation Range:

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Job Description Summary:

Job Requirements Prerequisites and Essential Functions:

Job Specifications:

Education:

• A.A degree in Business /Health Related field or equivalent experience in a health care setting required

Experience:

• Proficiency in medical terminology

• Experience in utilization review or discharge planning financial counseling or registration

• Minimum of 2 years of job related experience in a health care setting

• Proficiency with electronic health record (EHR) and other case management applications i.e. MIDAS

License and Certifications:

• Integrative Agitation Management (IAM) Required within 30 days of hire

Prerequisite Skills:

• Knowledge of available health care and community resources appropriate to the population served

• Knowledge of alternative levels of care including criteria required for payment and application processes

• Knowledge of transportation criteria

• Ability to carry out instruction provided in written or oral

• Ability to manage set priorities and operate with minimal direct supervision and can work effectively under pressure

Primary Customer Served (Age Specific Criteria):

• ( ) Infants: Birth up to 1 year

• ( ) Toddlers: 1 up to 3 years

• ( ) Preschool Children: 3 up to 6 years

• ( ) School Age Children: 6 up to 12 years

• ( ) Adolescents: 12 up to 18 years

• ( ) Early Adults: 18 up to 45 years

• ( ) Middle Adults: 45 up to 61 years

• ( ) Late Adults: 61 up to 80 years

• ( ) Late Late Adults: 80 years and up

Employees in this position must be able to demonstrate the knowledge and skills necessary to provide care and/or service based on the physical psycho/social educational safety and related criteria appropriate to the age of the patients served in his/her assigned service area.

Patient Privacy (HIPAA Compliance):
Employees in this position have access to protected health information. The protected health information a person in this position can access includes demographics date of service insurance/billing medical record summary information and all other information that may be contained in patient records. This position requires patient health information to perform the functions outlined as part of this position description.

Duties And Responsibilities:

Essential (Not Modifiable)

• Supports the utilization management process by entering requests for utilization review authorization of stay for concurrent and post billing denials to support case management workflow.

• Collaborates with case manager and social work staff as requested to provide post acute referrals for discharge needs.

• Executes the discharge plan developed by the care coordination team by initiating timely referrals to other services and facilities as necessary under the supervision of the case manager/social worker.

• Verifies benefits and prior authorization requirements from insurers and documents findings in the electronic medical record.

• Presents community resource lists and postacute care vendor lists as directed by the case manager.

• Independently and proactively initiates follow-up with post acute referral setting to ensure timely discharge.

• Provides the Second IM letter to Medicare patients prior to discharge and documents in the medical record.

• Documents accurately thoroughly and legibly in the medical record.

• Demonstrates proficiency in use and application of all electronic applications.

• Makes patient transportation arrangement as necessary insuring proper authorization from insurance source.

• Answers multiple and /or designated telephone lines able to prioritize and route calls

• Prepares denial letters as indicated per department policy and regulatory guidelines.

• Provides clerical support as needed including copying faxing and data entry.

• Collaborates with team members on interdependent tasks. Demonstrates both initiative and flexibility working with Physicians Case Managers and other staff.

• Ensures that routine and priority tasks are completed within established departmental time frames.

• Positively contributes to team decision making process in planning daily priorities resolving barriers to discharge plans seeking creative solutions.

Accommodation:

Qualified applicants with disabilities may request reasonable accommodation during the application process by contacting Human Resources at or .

C.A.R.E.S. Standards:

MarinHealth seeks candidates ready to model our C.A.R.E.S. standardsCommunication Accountability Respect Excellence Safetywhich foster a healing trust-based environment for patients and colleagues.

Health & Immunizations:

To protect employees patients and our community MarinHealth requires measles mumps varicella and annual influenza immunizations as a condition of employment (and annually thereafter). COVID-19 vaccination/booster remains strongly recommended. Medical or religious exemptions will be considered consistent with applicable law.

Compensation:

The posted pay range complies with applicable law and reflects what we reasonably expect to pay for this role. Individual pay is set by skills experience qualifications and internal/market equity consistent with MarinHealths compensation philosophy. Positions covered by collective bargaining agreements are governed by those agreements.

Equal Employment:

All qualified applicants will receive consideration for employment without regard to race color religion national origin sexual orientation gender identity protected veteran status or disability status and any other classifications protected by federal state and local laws.