Care Management Assistant - Full Time, Days

Care Management Assistant - Full Time, Days

Nursing --> Care Management

Patchogue, NY Full-Time/Regular

NYU Langone HospitalSuffolk

NYU Langone HospitalSuffolk is a 306-bed medical center, providing care to residents of eastern Long Island. The hospital facility is home to the Knapp Cardiac Care Centeran advanced heart disease diagnostic and treatment facilityas well as a modern ambulatory surgical pavilion with specialized services including women's imaging, a sleep laboratory, and bariatric surgery. Our Provisional Level 2 Trauma Center delivers comprehensive and specialized care for patients with traumatic injuries. The Stroke Center at NYU Langone HospitalSuffolk is designated by the New York State Department of Health as a Primary Stroke Center, with expert neurologists available to provide treatment 24 hours a day, 7 days a week. Additionally, NYU Langone HospitalSuffolk has multiple outpatient sites, including an outpatient wound care center, a hemodialysis center, and various primary care and specialty offices.

Position Summary:

We have an exciting opportunity to join our team as a Care Management Assistant - Full Time, Days - Care Management - Full-Time - Monday - Friday with Alt. In this role, the successful candidate Working under the direction of the RN Care Manager and LCSW, provides assistance in setting up post hospital care and services. Provides support to ensure that all care management documentation, communication, and information required to facilitate the discharge process are complete. Assists the Care Manager in the discharge planning process by assisting with the intake, tracking and communication of reviews to the payer. The main function of a case assistant is to provide support to case managers. While the exact job responsibilities vary by setting, they generally include performing administrative tasks, such as maintaining case files, updating referral information and verifying information related to health insurance or benefits. At time the case assistant may be required to interact with clients, perform initial intake interviews to determine the type of problem or need, support development of discharge plans in conjunction with case managers or social workers and aid in the review of treatment progress

Job Responsibilities:

• Transition Planning Performance Expectations: Participates in discharge planning activities as needed to ensure a timely patient discharge and appropriate linkage with post-acute providers. Assists in the research for preferred providers available to provide post hospital care to meet patient's needs. Contacts post-acute care providers and transmits information needed for referral process, and follows up to ensure timely communication and identification of available resources. Obtains payor certification for post-acute services. Collects, copies, and transmits pertinent clinical and patient demographic information required to complete arrangements for post discharge care and/or placement, as directed by the care managers and social workers. Coordinates and arranges transportation, DME and community services, as directed by the care managers and social workers. Maintains a working knowledge of community agency resources as required for role.
• Utilization Management Performance Expectations: Facilitates timely transmission of reviews to the payors in coordination with the care management team Communicates initial and concurrent clinical review information from Case Managers to payors via telephone and fax. Communicates any pertinent information received from payers to Care Managers Supports and assists with concurrent insurance denials and appeals process. Documents denials by type, payor, and appeal outcome. Provides denial and non-certified day information to Case Managers to reduce potential denials. Collaborates with Patient Access and Patient Financial Services to ensure accuracy of patient and payor information. Communicates updated information in a timely fashion. Ensures payor and customer satisfaction through effective communication and positive customer service skills at all times. Updates payor contact information to ensure accuracy.

Minimum Qualifications:

To qualify you must have a High School Diploma or GED Knowledge of medical terminology Computer skills: Word processing, spread sheets, email Excellent interpersonal skills in order to effectively communicate with internal and external customers. Excellent organizational and analytical skills necessary to manage multiple task simultaneously Able to work in a team structure. Self- directed, able to work independently. Good oral and written communication skills.

Preferred Qualifications:

Some knowledge of contractual reimbursement methodology. Some knowledge of insurance agencies and authorization process. Some knowledge of community agencies/resources preferred. Healthcare background preferred. Hospital experience a plus

NYU Langone HospitalSuffolk provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

NYU Langone HospitalSuffolk is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration.

NYU Langone Hospital-Suffolk provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $33,533.27 - $50,095.50 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

View the Pay Transparency Notice for further details.