Care Management Assistant - Case Management York Hospital - Days

Job Title

Administrative Services

Job Description

Full time (36 hours weekly) three 8 hour shifts, and one 12 hour shift works 6 weekends per year

General Summary

Performs a variety of duties related to facilitating the discharge planning process. Assists the Care Management team with the clerical functions. All tasks listed below may be expected in assigned daily work.

Responsibilities

Duties and Responsibilities Essential Functions:

• Assists with clerical functions (e.g., filing, copying, scanning, emailing, telephone, taking minutes)
• Determines patient health insurance benefit information as requested by CMRN/CMSW.
• Reviews payor logs and enters authorization information into EMR/patient record.
• Receives denial information and records in EMR/patient record; forwarding same to assigned CMRN.
• Initiates SNF authorizations as requested by CMSW/CMRN; followed by documentation of payor determination in EMR/patient record.
• Completes discharge notification to varied insurance payors.
• Assists CM team with IMM notices to patient.
• Assists with medication pricing as requested by CMRN/CMSW.
• Coordinates after care issues with the appropriate team members.
• Supports the CM team by coordinating follow up PCP appointments.
• Compiles data for and prepares regularly scheduled or special reports, analysis, and statements.
• Reviews daily patient discharge list, routes incomplete VNA orders, identifies incomplete auth information, reviews final disposition Epic navigator for accuracy and completeness.
• Works and maintains Incomplete Auth work queue; obtains delinquent authorizations and records in EMR.

Common Expectations:

• Maintains Downtime computer terminal/ associated logs.
• Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 2 years Relevant experience. Required

Licenses:

• Basic Life Support Upon Hire Required

Knowledge, Skills, and Abilities:

• Basic computer skills.
• Telephone etiquette.
• Good communication skills.
• Medical terminology preferred.

Benefits Offered:

• Comprehensive health benefits
• Retirement savings plan
• Paid time off (PTO)
• Education assistance
• Financial education and support, including DailyPay
• Expanded Paid Parental Leave

For additional details: Benefits & Incentives | WellSpan Careers

About Us

WellSpan Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.