Case Management Associate

4 weeks ago

Washington, Washington, D.C., United States MEDSTAR HEALTH Full time

General Summary of Position
Assesses the patient insurance/financial status to facilitate appropriate discharge planning. Uses departmental software to update hospital departments re: post hospital care referrals, provider contacts, and other related information. Serves as communication liaison between Clinical Case Managers, Social Workers and on-site reviewers. Interacts with Precert, PT/OT and Lombardi social worker/case managers. The functions are performed in accordance with all applicable laws and regulations and MedStar Georgetown University Hospital's philosophy, policies, procedures and standards.

Primary Duties and Responsibilities

Verifies patient insurance/financial status as required for access to posthospital care.Places orders for posthospital care and verifies that posthospital care is secured prior to patient discharge.Attends multi-disciplinary rounds on the nursing unit floors as scheduledUses software to update the Case Mgmt Dept, PFS and Precert re: post hospital care referrals and provider contacts, and all other discharge arrangements.Monitors Utilization Review Line 8 hours daily to communicate that insurance companies need clinical info from the case managers.Obtains patient medical records for patient referrals and/or discharge, as requested.Faxes referrals and chart copies as necessary.Facilitates weekly meetings and performs charge rotation in HR Coordinators/Supervisor's absence.Prepares billing confirmation documents for GUH to be responsible for payments of services for indigent patients, signed by the Director of Case Management, as requested.Answers the main telephone line, verifies that voice mail has been attended to daily &transfers calls appropriately.Serves as communication liaison between Clinical Case Managers, social workers and on-site reviewers.Communicates actual or potential problems with posthospital care, patient or provider relations to appropriateClinical Case Manager and supervisor immediately.Notifies supervisor if workload requires assistance and/or problems can not be resolved.Assumes other duties and responsibilities that are appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive.

Minimum Qualifications
Education

  • High School Diploma or GED required and
  • On-the-Job Training with two years post high school education or technical training, preferably in a health care related field. required and
  • Medical Terminology class attendance preferred

Experience

  • Previous directly related healthcare experience preferred

Knowledge, Skills, and Abilities

  • Demonstrable skill with word processing and spreadsheet management.
  • Ability to utilize the departmental software to communicate with internal case managers and Hospital Precert/Admissions.
  • Excellent verbal and written communication skills.

Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:

  • Strong emphasis on teamwork—our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
  • Strategic focus on equity, inclusion, & diversity—we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
  • Comprehensive total rewards package—including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
  • More career opportunities closer to home—as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.

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