Case Management Coordinator
2 weeks ago
We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels.
EducationHigh School Diploma or GED Required equivalent. Required Bachelor's degree Preferred Experience1-2 years 2 years clerical/office experience, including customer service experience, medical office experience preferred. Preferred Knowledge, Skills, and AbilitiesAbility to type 50 words per minute.Proficient with Microsoft Office Word and Excel.Ability to use multiple computer applications.Ability to operate standard office equipment.Ability to multitask and prioritize daily workload.Ability to work independently, as part of a team, and display innovation, capability, and initiative.Excellent verbal and written communication skills.Knowledge of medical terminology preferred.Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.Accountable for reviewing and screening incoming documents and reports and distribute to appropriate staff.Actively manages incoming calls to collect appropriate information, assesses and identifies caller needs with efficiency and/or to courteously direct the calls to the appropriate staff in a timely manner per MFC's guidelines.Acts as a liaison to providers and members to communicate status of authorization decisions or need for additional information.Compiles, prints and mails letters and educational materials to providers and members.Conducts monthly member and provider surveys and collects data for analyzing.Demonstrates behavior consistent with MedStar Health mission, vision, goals, objectives and patient care philosophy.Ensures complete communication (closes the loop and follow up) between key internal and external customers.Enters data into the clinical software system related to pre-authorization requests for pharmacy, non-pharmacy and hospitalizations.Maintains timely and accurate documentation in the clinical documentation system.Organizes and maintains data for targeted initiatives and maintaining timely outreach to members and providers as indicated.Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.Performs telephonic ACD (Automatic Call Distribution) phone line coverage for Clinical Operations' needs.Performs other duties as assigned.Plans meetings and complete detailed minutes.Processes telephone inquiries and communicates accurate knowledge of policies and procedures. Projects a positive image on the telephone to internal /external customers. Represents the best of MedStar Health (MFC) at all times and to all customers.Runs monthly reports, compiles analytical data for reporting, and identifies potential members for Case Management.Works collaboratively with the case management/ clinical team, and other customers internally and externally to meet the needs of the population.
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