What are the responsibilities and job description for the Case Management Specialist ARRMC (Case Management) position at Asante?
Additional Position Details: FTE: 1.000000 | Full Time | Variable Hours/Variable Days
Position Summary
The Case Management Specialist functions as a member of The Resource Management team. They utilize communication, organizational, and problem-solving skills to carry out the post-hospital care plans and interventions, utilization review and denials management activities as defined by the RN Discharge Coordinator and RN Utilization Reviewer. They assume a pivotal role with the patient care team to achieve optimal clinical and resource outcomes.
Key Responsibilities
Experience
Excellence - Respect - Honesty - Service - Teamwork
Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.
Position Summary
The Case Management Specialist functions as a member of The Resource Management team. They utilize communication, organizational, and problem-solving skills to carry out the post-hospital care plans and interventions, utilization review and denials management activities as defined by the RN Discharge Coordinator and RN Utilization Reviewer. They assume a pivotal role with the patient care team to achieve optimal clinical and resource outcomes.
Key Responsibilities
- Applies knowledge and skills necessary to effectively implement the post-acute care plan and utilization review activities as defined by the RN.
- Manages incoming payor correspondence, by fax or phone, including documentation of hospital authorizations and denials from the payors, indexing correspondence to the medical record, and faxing additional documentation as needed.
- Complies with all Asante , departmental policies and procedures, and regulatory requirements related to discharge planning and utilization review.
Experience
- 3 years of experience in administrative functions in care coordination and/or utilization management in healthcare settings is required.
- Experience with Microsoft Word and Excel required and experience with EPIC highly desired.
- Current understanding of CMS regulations related to hospital discharge requirements is preferred.
- Associates degree in business, healthcare administration or related field or equivalent is preferred.
- Earn a competitive and progressive salary
- Benefit from health plans that are focused on health and wellness including medical, dental, vision and wellness beginning within 30 days of hire
- On-call employees receive an additional 15% for flexibility
- Plan for your future with a retirement package that includes up to 6% employer contribution
- Experience a healthy work-life balance with our generous earned time off (ETO)
- Continue to enhance your education through our tuition reimbursement and tuition repayment plans
Excellence - Respect - Honesty - Service - Teamwork
Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.
