Care Management Assistant

Employment Status: Full time Shift: Day (United States of America) Facility: 1906 Belleview Ave SE - Roanoke Requisition Number: R162010 Discharge Assistant - Central Resource Center (Open) How You'll Help Transform Healthcare: The Throughput and Discharge Assistant supports efficient, high-quality, and cost-effective patient throughput and discharge operations across Carilion Clinic. Coordinates discharge-related administrative processes by scheduling peer-to-peer (P2P) reviews, gathering and distributing clinical and demographic information, maintaining payer documentation, and facilitating communication among providers, payers, and care teams. The Throughput and Discharge Assistant Prioritizes daily workflow to support efficient patient throughput and discharge operations, including managing faxes, voicemails, correspondence, and distribution of incoming communications. Coordinates P2P reviews by scheduling discussions between providers and payors, documenting determinations, communicating authorization decisions, and obtaining required demographic and clinical information. Supports utilization management and appeals processes by coordinating denial and appeal documentation, communicating with payors, Carilion billing, and care management teams, and assisting with insurance, benefits, and coverage inquiries. Processes health plan referral requirements, including prior authorizations, denial and appeal activities, and P2P requests related to admissions and patient progression. Performs federally mandated regulatory activities, including supporting Medicare Important Message (IM), Lifetime Reserve (LTR), Status Change, Code 44, and Notice of Medicare Non-Coverage (NOMNC) workflows. Coordinates required documentation, distributes notifications, and records delivery in the electronic medical record. Maintains Epic work queues, databases, spreadsheets, and departmental records to ensure accurate tracking, reporting, production, and distribution of utilization management and throughput activities. Researches and resolves administrative issues affecting patient progression and discharge to facilitate timely care transitions. Serves as a liaison among payors, providers, billing, patients, and care management staff by responding to inquiries regarding authorizations, approvals, denials, benefits, coverage, and insurance-related matters. Coordinates the timely collection of required documentation, signatures, and correspondence from internal and external stakeholders to support efficient discharge planning. Provides administrative support to utilization management physicians, nurses, and care management staff while assisting with departmental workflows and special projects. Travels between regional facilities and provides virtual and telephonic support across enterprise Care Management locations to meet operational and patient throughput needs. Maintains confidential records, prepares correspondence, manages office systems and equipment, and utilizes Microsoft Office applications and other software to support departmental operations. Communicates effectively with leadership, clinical staff, patients, visitors, vendors, and external agencies while maintaining excellent customer service in a fast-paced environment with frequently changing priorities. Maintains required competencies through continuing education, staff meetings, in-service training, and completion of required certifications. What We Require: Education: Associate’s degree or 2 years of experience may be considered in lieu of a degree. Experience: 2 years of experience in data collection and analysis and/or advanced administrative support required. Licensure, Certification, and/or Registration: Virginia Managed Long-Term Services and Supports (MLTSS/UAI) Certification required upon completion of orientation and must be maintained throughout employment. Other Minimum Qualifications: Advanced proficiency with Microsoft Office applications and database or spreadsheet software. Excellent communication, customer service, organizational, and problem-solving skills. Ability to manage multiple priorities, maintain confidentiality, and work effectively in a dynamic healthcare environment. This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description. Compensation Range: $17.39 - $24.35 Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan. Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at View phone number on click.appcast.io, 8:00 a.m. to 4:30 p.m., Monday through Friday. For more information on E-Verify: Benefits, Pay and Well-being at Carilion Clinic Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That’s why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life - at work and when you're away. When you make your tomorrow with us, we'll enhance your potential to realize the best in yourself. Comprehensive Medical, Dental, & Vision Benefits Employer Funded Pension Plan, vested after five years (Voluntary 403B) Paid Time Off (accrued from day one) Onsite fitness studios and discounts to our Carilion Wellness centers Access to our health and wellness app, Personify Health Discounts on childcare Continued education and training In our workplace, we're devoted to the success of our employees. No matter where you are in your career, we will help you continue to learn, grow, and share your knowledge with others. Introduce yourself to our recruiters and we'll get in touch if there's a role that seems like a good match. Join an organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, fully dedicated, and forever curious. Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, and multi-specialty physician practices spanning southwestern Virginia. Join us and begin your career in a place where every day is a new adventure of creating the future of health care. #J-18808-Ljbffr