Department: Integrated Care Management

Hours per pay period: 80

Schedule: 8 a.m. - 4:30 p.m.

Position Summary:

Responsible for providing assistance to the RN and SW Care Managers in the coordination of discharge and transition plans, as well as, performing clerical functions to ensure the efficient operation of the ICM department.

Essential Functions and Responsibilities as Assigned:

1. Assists with facilitating discharge planning to expedite a successful transition of care.

2. Assists RN and SW Care Managers with the referral process by collecting and distributing informational brochures/pamphlets that enhance patient/family choice of providers, agencies and other professional health care services.

3. Assists with the coordination post discharge placement and services by making referrals, confirming specific placement and service arrangements, processing, organizing and obtaining insurance verification and/or prior authorization from insurance companies for discharge arrangements.

4. Assists with contacting community resources to coordinate discharged transition plans while using professional tact and diplomacy skills between patients, colleagues and community.

5. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON) completion.

6. Communicates pertinent documentation to nursing and homecare facilities to expedite patient discharges for assigned patients.

7. Assists with contacting community resources to coordinate discharged transition plans while using professional tact and diplomacy skills between patients, colleagues and community.

8. Attends meetings and prepares agendas and minutes.

9. Handles incoming and outgoing office correspondence; answers and directs department phone calls as needed.

10. Performs general office duties including faxing, copying, scanning and filing. Orders department supplies.

11. Tracks and communicates bed availability at area extended care and rehab facilities.

12. Communicates with internal and external customers to answer questions.

13. Troubleshoots problems that arise with office equipment. Notifies leadership of unresolved issues.

14. Performs other related duties as required and directed.

Required

• Associate degree in healthcare-related field

• Two years of clerical experience

• One-year experience in a heath care environment utilizing medical terminology or have completed a college level course in medical terminology

Preferred:

• Bachelor’s degree in coding/medical records/billing or UM

• Two years of case management or utilization review experience

• Three years of recent experience doing third party payer certification