Case Manager - MA/LPN

Job Description

Job Description

GENERAL DESCRIPTION

The role of the Case Manager is responsible for ensuring a smooth registration process for new patients and efficient appointment scheduling for new and existing patients. The Case Manager will be responsible for coordinating appointments between patients and appropriate healthcare providers in accordance with the Company’s policies and procedures, maintain accurate records, and providing exceptional customer service.

AREAS OF RESPONSIBILITY

A successful Case Manager will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.

The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and / or eliminate function(s).

• Appointment Scheduling : Schedule appointments for patients with healthcare providers based on availability, medical urgency, and patient preferences. Ensure all providers (which includes pharmacists, medical social workers, etc.), nurses, etc. Schedules are fully optimized.
• Patient Communication : Interact with patients via email, patient portal, telephone, text, in-person, etc. to gather necessary information, schedule and confirm appointments, and provide pre-appointment instructions. Respond to patient inquiries, resolve scheduling conflicts, and assist in rescheduling appointments when necessary.
• Records Management : Maintain accurate and up-to-date patient records, including demographic information, contact details, insurance information, appointment history, etc. Ensure confidentiality and adhere to privacy regulations when handling sensitive patient information.
• Coordination with Healthcare Providers and Staff : Collaborate closely with care team members and other staff members to ensure optimal scheduling and coordination of patient care. Communicate changes, cancellations, or rescheduling of appointments to relevant parties in a timely manner. Communicate with providers and staff via phone, email, Teams, Athena, or in-person.
• Insurance Verification : Verify insurance coverage and eligibility for patients ensuring accurate documentation of insurance information at all times. Collaborate with the billing department to address any insurance-related issues or concerns.
• Workflow Optimization : Continuously assess and improve appointment scheduling processes to enhance office efficiency and productivity. Identify areas for improvement and propose solutions to streamline operations.
• Customer Service : Provide exceptional customer service to patients, exhibiting a compassionate and empathetic attitude. Address patient concerns, inquiries, and complaints professionally and promptly, striving to meet patient needs and ensure their satisfaction.
• Administrative Functions : Perform general administrative tasks and support other staff as needed. Work assigned buckets, ticklers, census lists, and region’s scheduling voicemail tasks. Utilize the company’s software systems to enhance patient care and staff productivity.
• Collaboration and Coordination : Collaborate with internal and external resources to facilitate and ensure seamless operations.
• Communicate with patients, families, and caregivers.
• Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and / or projects.
• Utilize the company’s software systems and update information as required.
• Participate in coaching calls.
• Perform other duties as requested or required, in the sole discretion of the Company.

MISSION EXPECTATIONS

Take responsibility for own work in completing tasks. Assist others so that the resources, assistance, or support is provided to achieve success in their daily work.

WORK ENVIRONMENT

The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job :

COMPLIANCE WITH POLICIES AND PROCEDURES

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.

QUALIFICATIONS

High school diploma or equivalent required while an associate’s or bachelor’s degree in healthcare is preferred.