Care Management Associate - Case Management - Mid Shift(12:00p-8:30p) - FT - Orange

UCI Health Care Coordinator

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County's only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region's only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Position Summary: In collaboration with the case manager, patient/family, healthcare team and payors, incumbent coordinates the care services for assigned patients for an episode of illness or treatment as defined by the case manager. Promotes the effective utilization of resources using current knowledge and awareness of community resources to achieve optimal care. This includes assisting with discharge planning, insurance verification & authorization, obtaining necessary resources, sending referrals, making follow up medical appointments, and appropriate documentation of activities in all required computer systems.

What It Takes to be Successful Required Qualifications: Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties Must demonstrate general understanding of medical terminology Must demonstrate customer service skills appropriate to the job Minimum of 2 years experience in a hospital or medical office setting Extensive and demonstrated knowledge of Government and Commercial Insurance Plans Experience with registration and/or billings computer software programs Excellent written and verbal communication skills in English Demonstrated knowledge and understanding of Managed Care plans Demonstrated experience with referral authorization process Demonstrated experience with MS Office (Word, Excel, Outlook) Demonstrated ability to utilize payer and government websites to access and interpret health plan benefit packages and make determinations Ability to work weekends, holidays, and evenings Ability to maintain a work pace appropriate to the workload Ability to interpret and understand various medical insurance plans and make accurate determinations regarding coverage Ability to establish and maintain effective working relationships across the Health System Preferred Qualifications: Knowledge of UCI policies and procedures