Case Management Assistant

Division: University Hospital

Department: SOC WORK/CASE MGT CORE ADULTS

Schedule: Full-Time

Shift: AM

Hours:

Job Details:

• - HS Diploma or equivalent

Job Summary: This position will support LLUMC's strategic plan and the organization's mission to continue the teaching and healing ministry of Jesus Christ, while embracing the core values of Compassion, Integrity, Excellence, Teamwork, and Wholeness. The Case Management Assistant (CMA) collaborates with Case Managers and Social Workers in assisting with the continuum of care and discharge planning. The CMA is responsible for communication of clinical information, referrals and coordination of insurance review. The CMA collaborates with the PBO (Patient Business Office) for identification of payer sources/eligibility/indigent programs, completes TAR's (Treatment Authorization Requests) for submission to the county field offices for medical authorization, supports medical on-site reviewer functions, assists with reimbursement/authorization contracts, and supports the denials/appeals process. The CMA is able to function under the direction of a Case Manager with minimal supervision, takes responsibility for professional growth, and assists in the coordination of patient placements, ordering of durable medical equipment and coordinating care transitions. Performs other duties as needed. Job Specifications: Acquires and maintains working knowledge of Medi-Cal, CCS, CMS and commercial regulations and managed care; Knowledge of state managed health plans and contracting. Able to read; write legibly; speak in English with professional quality; use computer and software programs necessary to the position; Operate/troubleshoot basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; able to demonstrate positive customer service skills; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; work independently with minimal supervision; perform basic math functions; manage multiple assignments effectively; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail; maintain confidential records and correspondence. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.High school diploma or equivalent required; Two years post high school education in related field preferred; three years' experience with a medical group, managed care organization, utilization management, hospital admitting, or medical nursing unit required; hospital and/or insurance experience preferred. Medical Assistant Certification preferred.

EOE AA M/F/Vet/Disability