Patient Care Coordinator/Case Management Specialist/UM

Job Description

Job Description

Position Summary

The Case Management Assistant provides administrative and operational support to the Case Management and Utilization Management teams to facilitate efficient patient care coordination, discharge planning, and resource management. This role assists with documentation, data entry, referrals, authorizations, and communication among healthcare providers, patients, payers, and community resources while ensuring compliance with organizational policies and regulatory requirements.

Key Responsibilities

Case Management Support

• Assist Case Managers with patient care coordination and discharge planning activities.
• Support patient transitions of care by coordinating referrals, appointments, and post-acute services.
• Maintain accurate and timely documentation within the Electronic Health Record (EHR).
• Monitor and track case management activities, authorizations, and follow-up requirements.

Utilization Management Support

• Assist with utilization review processes, including data collection and documentation.
• Coordinate communication with payers regarding authorizations, eligibility verification, and coverage determinations.
• Track utilization management requests and ensure timely submission of required documentation.
• Support compliance with payer guidelines and organizational utilization management protocols.

Administrative Functions

• Manage patient records, reports, and case management documentation.
• Schedule meetings, maintain department logs, and prepare reports as requested.
• Respond to inquiries from patients, families, providers, and community agencies.
• Ensure confidentiality and compliance with HIPAA regulations.

Collaboration & Communication

• Serve as a liaison between Case Managers, physicians, nursing staff, payers, and external agencies.
• Communicate effectively regarding patient care plans, discharge needs, and resource utilization.
• Participate in departmental meetings and quality improvement initiatives.

Compliance & Quality

• Maintain compliance with organizational policies, regulatory requirements, and accreditation standards.
• Support quality improvement initiatives related to case management and utilization review processes.
• Perform other duties as assigned.

Required Qualifications

Education

• High School Diploma or GED required.

Experience

• Minimum of three (3) years of experience in a healthcare setting; OR
• One (1) year of experience in Utilization Management or Case Management within a Medical Group, Acute Care Hospital, Health Plan, or Managed Care environment.

Technical Skills

• Experience using Electronic Health Records (EHR) systems.
• Knowledge of Utilization Management applications such as EPIC, 3M, or similar healthcare software.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook).

Preferred Qualifications

Education

• Associate Degree in Healthcare Administration, Health Information Management, Business Administration, or a related field preferred.

Experience

• Prior experience as a Case Management Assistant strongly preferred.
• Experience supporting Utilization Management, Care Coordination, Discharge Planning, or Case Management teams.

AlphaProTemps is specialized in providing "best-in-class" professional staff augmentation services. These recruiting directives include temporary labor, contract sourcing, professional & technical niches, vendor-on-site, and managed service programs.

Company Description

AlphaProTemps is specialized in providing "best-in-class" professional staff augmentation services. These recruiting directives include temporary labor, contract sourcing, professional & technical niches, vendor-on-site, and managed service programs.