Case Management Assistant

The Case Management Assistant at MD Anderson Cancer Center provides support services to ensure pre-certification, authorization, and payment for inpatient services, while facilitating the acquisition of equipment and services necessary to support the continuum of care. This role works closely with patients, families, insurance payors, vendors, and the interdisciplinary healthcare team to help ensure timely care transitions and successful discharge planning.

The ideal candidate will have an Associate's Degree in Business Administration, Healthcare Administration, or a related field and three years of administrative experience in healthcare, insurance, or a related field. Candidates with a preferred Bachelor's Degree may qualify with one year of related experience. The ideal candidate must be available to work on-site Monday through Friday, 8:30 AM - 5:00 PM. Remote work may be permitted approximately 10% of the time. This team participates in a rotating Saturday schedule, and the CMA will be required to work one Saturday approximately every eight weeks, with a flex day provided during the week leading up to the Saturday shift.

Case Management provides comprehensive support for discharge planning, utilization management, insurance authorization, and care coordination. The Case Management Assistant serves as a key resource in facilitating timely approvals, equipment acquisition, and communication among patients, families, providers, payors, and community resources.

Hourly breakdown of salary range:
Minimum $21.88 | Midpoint $27.40 | Maximum $32.93

MD Anderson Offers Our Employees:
• Paid employee medical benefits (zero premium) starting on the first day for employees working 30+ hours per week
• Group Dental, Vision, Life, AD&D, and Disability coverage
• Paid Time Off (PTO) and Extended Illness Bank (EIB) paid leave accruals
• Paid institutional holidays, wellness leave, childcare leave, and other paid leave programs
• Tuition Assistance Program after six months of service
• Teachers Retirement System defined benefit pension plan and two voluntary retirement plans
• Employer paid life, AD&D, and illness related reduced salary pay program
• Health Savings Account and Dependent Care Reimbursement flexible spending accounts
• Fertility benefits
• State of Texas longevity pay
• Extensive wellness, recognition, fitness, employee health programs, and employee resource groups

The University of Texas MD Anderson Cancer Center is ranked the nation's top hospital for cancer care by U.S. News & World Report's "Best Hospitals." Our mission is to eliminate cancer in Texas, the nation, and the world through exceptional programs that integrate patient care, research, and prevention.

Essential Job Functions:
• Provide support services to ensure pre-certification, authorization, and payment for inpatient services and facilitate the continuum of care for patients
• Coordinate acquisition of equipment between insurance companies, vendors, healthcare teams, and patients/family members
• Review patient medical records to provide clinical information to insurance payors for services
• Review patient medical records to obtain authorization for continued inpatient hospitalization
• Ensure completeness of Certificates of Medical Necessity (CMNs), including diagnosis codes, medical documentation, and length of need requirements
• Document information necessary to facilitate appeals for denied services, insurance verification, benefits verification, and discharge planning
• Obtain missing insurance information from patients as appropriate
• Provide copies of Medicare notices for regulatory purposes as directed
• Communicate insurance and Medicare issues with patients, access centers, interdisciplinary team members, and other departments involved in patient care
• Reconcile and maintain task lists to assign and reassign utilization reviews
• Utilize CARE, Maxsys, InterQual, and CARE templates for documentation
• Maintain durable medical equipment (DME) vendor relationships
• Other duties as assigned

Education Required: Associate's Degree in Business Administration, Healthcare Administration, or related field
Education Preferred: Bachelor's Degree in Business, Healthcare Administration, or related field
Experience Required: Three years of administrative experience in healthcare, insurance, or related field; with a preferred degree, one year of related experience may be considered
Experience Preferred: None
Other Required: May substitute required education with additional years of equivalent experience on a one-to-one basis

The University of Texas MD Anderson Cancer Center offers excellent benefits , including medical, dental, paid time off , retirement , tuition benefits, educational opportunities, and individual and team recognition.

This position may be responsible for maintaining the security and integrity of critical infrastructure, as defined in Section 113.001(2) of the Texas Business and Commerce Code and therefore may require routine reviews and screening. The ability to satisfy and maintain all requirements necessary to ensure the continued security and integrity of such infrastructure is a condition of hire and continued employment.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state, or local laws unless such distinction is required by law.

Additional Information

• Requisition ID: 181941
• Employment Status: Full-Time
• Employee Status: Regular
• Work Week: Day/Evening
• Minimum Salary: US Dollar (USD) 45,500
• Midpoint Salary: US Dollar (USD) 57,000
• Maximum Salary : US Dollar (USD) 68,500
• FLSA: non-exempt and eligible for overtime pay
• Fund Type: Hard
• Work Location: Onsite
• Pivotal Position: No
• Referral Bonus Available?: No
• Relocation Assistance Available?: No

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