Transitions Assistant, Toc

3 weeks ago

Edison, United States Hackensack Meridian Health Full time

Overview:
Our team members are the heart of what makes us better.

At **Hackensack Meridian **_Health_** we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The **Transitions of Care Assistance Assistant** works closely with Regional Manager, Transitions of Care (TOC) Navigator, physicians and staff in coordinating and communicating gaps in quality care metrics for all TOC patients. They assist with patient navigation and preventative screening compliance. The TOC Assistant works independently to audit clinical data. This promotes workflows that support quality patient care and compliance with documentation and clinical outcome metrics. The TOC Assistant will communicate with the healthcare team to assist patients in transitions of care across the healthcare continuum. The TOC is accountable along with the TOC Navigator to meet clinical quality guidelines and facilitate high quality safe patient care.

This position is based in our Southern region.

**Responsibilities**:
A day in the life of a **Transitions of Care Assistance Assistant** at Hackensack Meridian Health includes:

- Audits clinical records for gaps in quality care metrics and follows a corrective plan with guidance from TOC Navigator to facilitate collections and reporting of required quality metrics.
- Assist in workflow design that promotes compliance to TOC standards and clinical quality metrics.
- Provide weekly reports to TOC Navigator to assist with quality metrics performance that will maximize metrics compliance.
- Will work with providers, care coordinators and hospital staff to ensure safe patient transitions.
- Accountable for preventative care metric documentation.
- Contacts TOC patients to make appointments for outstanding provider follow ups, transportation and discharge phone calls under the direction of the TOC Navigator.
- Performs both inpatient and outpatient audits for Managed Medicaid HMO payers. Communicates gaps in quality metrics to Regional Manager and TOC Navigator on a weekly basis.
- Assist practice in scheduling appointments and referrals which improves accessibility of office services and patient satisfaction. In addition to the timely transmission of Electronic Health Records to the next level of care provider.
- Travel to other assigned HMH hospitals to ensure compliance with TOC policies, procedures and initiatives as directed by the Regional Manager.
- Work with management and TOC Navigator to utilize EPIC software to create and report on TOC outcome measures such as ER, inpatient and outpatient quality metric results.
- Audit medical records to ensure documentation conforms to TOC standards for inclusion and exclusionary clinical guidelines.
- Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
- Adheres to the standards identified in the Medical Center's Organizational Competencies.

Qualifications:
**Education, Knowledge, Skills and Abilities Required**:

- Associate's degree or relevant years in healthcare, medical insurance billing, auditing or related field.
- Excellent analytical skills.
- Good reasoning and problem solving ability.
- Highly developed interpersonal skills.
- Proficient at multitasking and prioritization.
- Ability to work independently as well as in a team environment.
- Highly organized.
- Good presentation skills.

**Education, Knowledge, Skills and Abilities Preferred**:

- Registry skills.
- Experience with auditing commercial medical insurance payers.
- Bilingual preferred.
- Experience in a variety of patient settings.

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