Case Management Assistant

Utilization Management Case Manager

Receive 17 Weekday Nights 26 Weekend Nights and 15 Weekend Day shift differentialsMinimum Offer $16.59/hr.Maximum Offer $22.95/hr.Compensation DisclaimerCompensation for this role is based on a number of factors including but not limited to experience education and other business and organizational considerations.

Position Summary:

Under the supervision of department Director or designee assist in providing case management services assist in some aspects of the admissions and discharge process to facilitate smooth and timely admission and discharge and appropriate referral to available resources. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include neonate pediatric adolescent adult and geriatric age groups.

Detailed responsibilities:

• Arrange meals lodging and transportation for families as requested
• Assist in coordinating medical equipment and supplies for home use communicating with appropriate members of treatment team family and patient as directed
• Assist in making arrangements for home health services as directed
• Communicate plans for equipment transportation referrals etc. as appropriate to members of the treatment team perform follow-up communication with patients or appropriate designee as needed
• Communicate with appropriate staff patients or designees and outside agencies regarding any necessary financial information as directed
• Assist with coordinating transfer of patients to appropriate settings i.e. acute care psychiatric inpatient skilled nursing facility or other destinations
• Coordinate patient care conferences as requested
• Participate in patient care team meetings to review follow-up actions and patient discharge planning
• Formulate copy fax and distribute correspondence and medical records as directed
• Collect and enter required data prepare reports as directed
• Answer phones obtain appropriate information respond to requests and transfer calls retrieve messages take information and route as appropriate
• Assist patient or designee in completing patient assistance forms/documentation and maintain records
• Verify coverage eligibility on patients for outside services as needed
• Coordinate and obtain missing information related to denials due to the lack of notification authorization
• Establish maintain process and update files records and/or other documents
• Maintain resources and reference materials direct referrals to community agencies as needed
• Enhance professional growth and development through participation in educational programs reading current literature attending in-services meetings and workshops
• Follow patient safety-related policies procedures and protocols
• Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes
• Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk
• Report potential or actual patient safety concerns medical errors and/or near misses in a timely manner
• Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right"

Qualifications:

Education:

• Essential: High School or GED Equivalent
• Nonessential: Associate Degree Bachelor's Degree
• Education specialization: Nonessential: Related Discipline

Experience:

• Essential: No minimum experience required
• Nonessential: Medical terminology knowledge Bilingual English Spanish Keres Tewa Tiwa Towa Zuni or Navajo Bilingual English/Vietnamese Case management experience Utilization management experience 2 years directly related experience

Credentials:

• Essential: Not Applicable/Not Required

Physical Conditions:

• Light Work: Exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. May require walking or standing to a significant degree or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls and/or may require working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of materials is negligible.
• Working conditions: Essential: Minor Hazard - physical risks dirt dust fumes noise Tuberculosis testing is completed upon hire and additionally as required