Job Details

SUMMARY

This position is responsible for organizing workflow, managing communications, tracking critical information, creating reports, and establishing links with community resources. The position is also responsible for optimizing the Case Management process and the Case Manager's efficiency and effectiveness by performing the following duties.

• Provides support to Clinical Operations staff and the Director of the department as directed.
• Completes special projects or duties to assist assigned team Case Managers.
• Indexes and creates authorizations in the appropriate software program.
• Acts as a resource and provides training to Case Assistant I team members.
• Works closely with RN Case Managers and Utilization Reviewers to ensure accurate and complete required documentation that meets risk management and regulatory requirements.
• Performs administrative tasks which include filing, scanning, database management, and data entry.
• Assists RN Case Managers with the coordination of medical services to ensure the delivery of high-quality cost-effective healthcare services.
• Executes all duties in accordance with State and Federal requirements to achieve optimal outcomes for members.
• Assists with preparation of reports and spreadsheets.
• Prepares member correspondence and other written communication as needed.
• Triages telephone calls and routes to appropriate staff as necessary.
• Proactively identifies and resolves issues to promote positive outcomes for members.
• Promotes communication, both internally and externally, to enhance effectiveness of case management services.
• Processes Benevolent Fund requests.
• Assists with special populations and/or projects as assigned.
• Performs member outreach.
• Maintains confidentiality and complies with HIPAA rules and regulations.
• Maintains punctual, regular and predictable attendance.
• Works collaboratively in a team environment with a spirit of cooperation.
• Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members, providers, and community partners and including the ability to communicate effectively and remain calm and courteous under pressure.
• Respectfully takes direction from manager.

EDUCATION and/or EXPERIENCE

High school diploma or general education degree (GED); and three to five years of related experience and/or training in a medical clinic or other healthcare environment. Knowledge and understanding of medical coding, medical abbreviations, and medical terminology.

COMPUTER SKILLS

Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, word processing, communicate by e-mail and use scheduling software. Experience with Electronic Medical Records, Electronic Health Records, and/or other Health Information related technology.

CERTIFICATES, LICENSES, REGISTRATIONS

CNA or MA certification is preferred.

We provide a competitive salary and excellent benefits, including vacation, medical, dental and vision insurance, and 401(k) pension plan. To apply for this position, please submit a cover letter and resume. We are an Equal Opportunity Employer.

Onsite Position

Background Check & Drug Screen Required