Case Management Assistant - Utilization Management
We are currently seeking a Case Management Assistant to join our Utilization Management team. This position works on campus, part-time, .6 (48 hours per 2-week pay period), 8:00 am - 4:30 pm, and every other weekend. Under general supervision, coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of department goals. Assist in discharge planning to facilitate the delivery of cost-effective healthcare and assists in the identification of appropriate utilization of resources. Works collaboratively with interdisciplinary staff internal and external to the organization. Participates in quality improvement and evaluation processes related to the management of patient care.
Responsibilities:
- Completes tasks as assigned by Clinical Coordinator or Social Worker
- Makes referrals for post-acute services under the direction of the Clinical Coordinator or Social Worker team members utilizing the electronic Case Management system
- Verifies patient demographic data
- Provides patients and families with list of choices of post-acute providers per policy
- Responds to post-acute providers timely and completes referrals per policy
- Documents and communicates all elements of the post-acute referral to the Clinical Coordinator or Social Worker and the healthcare team, patient/family, and post-acute providers
- Makes copies, sends faxes, and completes phone calls to arrange discharge to post-acute services and to ensure that appropriate hospital information is communicated to post-acute providers
- Documents all referrals and tasks in the electronic health record
- Provides patients and healthcare team information regarding resources and benefits available to the patient along with the economic impact of care options
- Assists with obtaining necessary supplies and/or medical equipment for patient discharge
- Arranges transport and obtain authorization as necessary
- Arranges follow-up appointments
- Completes Pre-Admission Screening (PAS) form for nursing facilities as directed
- Accesses electronic systems, such as MNIT-S to determine patient eligibility information
- Delivers Important Message from Medicare (IMM) or Administer first IMM within two days of admission and second IMM within two days of discharge (if not done by Patient Access)
- Documents second IMM was administered in designated area in EMR. Ensure copy of signed second IMM is in the medical record
- Assist UR nurse with clerical support (faxing, follow-up calls) for payor reviews or authorizations
- Follows organizational policies and procedures and standard work to complete job functions
- Establishes and maintains effective communication with all referral sources
- Performs other duties as assigned
Qualifications:
Minimum Qualifications:
- High school diploma -OR- An approved equivalent combination of education and experience
Preferred Qualifications:
- 2-year degree in Accounting, Business, Healthcare Administration, Health & Human Services or related field
- 2 years of healthcare experience
- Experience with medical terminology and electronic health record systems
- Paramedic, EMT or Nursing Assistant certification preferred
Knowledge/ Skills/ Abilities:
- Demonstrated skills in the areas of communication (verbal and written), conflict, interdisciplinary collaboration, management, creative problem solving, and critical thinking
- Excellent verbal and written communication skills required
- Demonstrates flexibility via an ability to adapt to changing priorities and regulations
- Epic
- MS Office
Location: MN-Minneapolis-Downtown Campus
Requisition ID: 251772