Case Management Assistant

3 weeks ago

Pasadena, United States Memorial Hermann Health System Full time

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Under the general direction of the Case Management Director, the Case Management Assistant provides support to the Case Management team, physicians, and medical office staff office. The CM Assistant facilitates resolution of issues, gathers pertinent information for use by the team, participates in outreach to patients/families, and facilitates processes that promote successful care transitions.Job Description

Minimum Qualifications:

Education: Associate's Degree, preferred.

Licenses/Certifications: One of the following is preferred:

  • Certified Nursing Assistant (C.N.A)
  • Licensed Vocational Nurse (L.V.N)
  • Respiratory Therapist
  • Certified Medical Assistant
  • EMT certification by the Texas Department of State Health Services
  • Licensed Paramedic by the Texas Department of State Health Services
Experience / Knowledge / Skills:
  • Minimum of one year experience in a health care setting.
  • Experience working directly with patients, physicians and other caregivers required.
  • Experience providing patient education in a clinic or outpatient setting preferred.
  • Ability to demonstrate knowledge of the Medical Home Initiative, and to work with payors, case managers, business office support and others to facilitate the appropriate and cost-effective use of resources.
  • Proficient in word processing and spreadsheet software with basic knowledge of database applications.
  • Demonstrate superior written and verbal communication skills and negotiation skills, as well as ability to manage multiple tasks and priorities simultaneously.
  • Effective oral and written communication skills.
Principal Accountabilities
  • Participates in the development of patient educational programs, in conjunction with MHMD and CPC subcommittees.
  • Provides information, guidance and support to the Case Management team relative to the development of individualized plans of care.
  • Acts as resource to Case Managers in the provision of services on an inpatient and ambulatory basis.
  • Acts as a liaison between Case Managers and the Medical management team in response to specific program issues.
  • Maintains current expertise in standards and criteria utilized by third-party payor expectations, and NCQA's Medical Home Standards.
  • Provides information to CBO for review and update of Insurance Rules screens, in order to assure that timely and accurate contract information is available to Medical Management team at all times.
  • Tracks denial by type, payor, appeal outcome, documents in appropriate TQ screens, and reports denial trends.
  • Provides organizational support and input to the MHMD/Inpatient Care Management teams.
  • Provides denial and non-certified day information to Case Managers to reduce potential denials as appropriate.
  • In collaboration with physicians and other providers, initiates and delivers denials as appropriate.
  • In collaboration with the PCP or Physician Advisor, review and provides input into the appeal process as needed.
  • Provides outreach to patients/families and physicians in accordance with goals set within contractual and clinical outcome metrics.
  • Ensures quality, safe care to populations managed and targeted within programs at One Memorial Hermann, adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
  • Participates in discharge planning activities (e.g. contact with post acute care facilities, other community resources and transportation) as needed to assure safe patient transitions from hospital to home and appropriate linkage to post acute providers.
  • Participates in performance improvement activities of the department and One Memorial Hermann.
  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
  • Other duties as assigned.

  • Case Manager

    4 weeks ago

    Pasadena, United States Memorial Hermann Health System Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Case Manager

    2 months ago

    Pasadena, United States Joe I. Zaid & Associates, PLLC Full time

    Essential Duties and Responsibilities: - Handle personal injury case files from start to finish with mínimal supervision - Evaluate potential personal injury claims and provide legal advice to prospective clients accordingly - Communicate with clients, expert witnesses, insurance company adjusters, supporting witnesses, and medical providers to gather...

  • Case Manager

    2 weeks ago

    Pasadena, United States Social Vocational Services Full time

    **Job description** Social Vocational Services is a nonprofit organization, which for over 41 years has been committed to serving the needs of individuals with developmental disabilities. SVS takes pride in its dedicated staff and is currently seeking dependable, caring individuals to become part of its team. **Position**:Case Manager **Description**:...

  • Case Manager

    4 weeks ago

    Pasadena, United States Alpha Consulting Full time

    Join to apply for the Case Manager role at Alpha Consulting Corp. 1 month ago Be among the first 25 applicants Join to apply for the Case Manager role at Alpha Consulting Corp. Save this job with your existing LinkedIn profile, or create a new one. Save this job with your existing LinkedIn profile, or create a new one. Your job seeking activity is only...

  • Case Manager

    4 days ago

    Pasadena, California, United States Alpha Consulting Full time

    Join to apply for the Case Manager role at Alpha Consulting Corp.1 month ago Be among the first 25 applicantsJoin to apply for the Case Manager role at Alpha Consulting Corp.Save this job with your existing LinkedIn profile, or create a new one. Save this job with your existing LinkedIn profile, or create a new one. Your job seeking activity is only visible...

  • Case Manager

    2 weeks ago

    Pasadena, United States SSHA Full time

    A small community 36-bed facility has a full-time Case Management position available. The Case Manager has well-developed knowledge and skills in areas of utilization management (UM), and Discharge Planning. This individual supports the Case Management program by developing and/or maintaining effective and efficient processes for determining the appropriate...

  • Case Management Coordinator

    2 weeks ago

    Pasadena, United States Imperial Health Plan of California Full time

    _**People are the most important asset of Imperial**_, _for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a...

  • Director Case Management

    4 weeks ago

    Pasadena, United States HCA Houston Healthcare Southeast Full time

    This position is incentive eligible. **Introduction**: Do you have the career opportunities as a Director Case Management you want with your current employer? We have an exciting opportunity for you to join HCA Houston Healthcare Southeast which is part of the nation's leading provider of healthcare services, HCA Healthcare. **Benefits**: HCA Houston...

  • Director of Case Management

    4 weeks ago

    Pasadena, United States Memorial Hermann Health System Full time

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...

  • Registered Nurse Case Manager

    2 weeks ago

    Pasadena, United States HCA Houston Healthcare Southeast Full time

    **Introduction**: Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Registered Nurse Case Manager with HCA Houston Healthcare Southeast you can be a part of an organization that is devoted to giving back! **Benefits**: HCA Houston Healthcare Southeast, offers a total rewards package that supports...

  • Case Manager I

    3 weeks ago

    Pasadena, United States HealthRIGHT 360 Full time

    Job Overview This is a union position.Pasadena Outpatient Behavioral Health Services provides comprehensive mental health services for our community ages birth through older age. Our continuum of care ranges from prevention and early intervention to intensive outpatient services for those with more serious and chronic conditions, including Full-Service...

  • Case Manager I

    2 weeks ago

    Pasadena, United States HealthRIGHT 360 Full time

    Job Overview This is a union position.Pasadena Outpatient Behavioral Health Services provides comprehensive mental health services for our community ages birth through older age. Our continuum of care ranges from prevention and early intervention to intensive outpatient services for those with more serious and chronic conditions, including Full-Service...

  • Registered Nurse Manager Case Manager

    3 days ago

    Pasadena, Texas, United States HCA Houston Healthcare Southeast Full time

    Description IntroductionDo you have the career opportunities as a(an) Manager Case Manager you want in your current role? We invest in what matters most to nurses like you – at home, at work, and at every stage in your career. We have an exciting opportunity for you to join HCA Houston Healthcare Southeast which is a part of the nation's leading provider...

  • Registered Nurse Manager Case Manager

    2 weeks ago

    Pasadena, United States HCA Houston Healthcare Southeast Full time

    Description IntroductionDo you have the career opportunities as a(an) Manager Case Manager you want in your current role? We invest in what matters most to nurses like you – at home, at work, and at every stage in your career. We have an exciting opportunity for you to join HCA Houston Healthcare Southeast which is a part of the nation’s leading...

  • Case Manager I

    1 month ago

    Pasadena, United States HealthRIGHT 360 Full time

    2650 E Foothill Blvd, Pasadena, CA 91107, USA Req #738 Tuesday, April 9, 2024 HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment. Our Outpatient services specialize in...

  • Case Manager, Homelessness Prevention

    3 weeks ago

    Pasadena, United States Door of Hope Full time

    Are you interested in making a difference in the lives of families facing homelessness? Are you searching for not just a job, but a calling? Door of Hope, a Christian, faith-based nonprofit that empowers families facing homelessness to transform their lives, is hiring a Case Manager to be part of our life-changing work. As a Case Manager you will work with...

  • Registered Nurse Case Manager

    1 week ago

    Pasadena, United States HCA Houston Healthcare Southeast Full time

    **Introduction**: Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Registered Nurse Case Manager today with HCA Houston Healthcare Southeast. **Benefits**: HCA Houston Healthcare Southeast, offers a total rewards...

  • Case Manager I

    1 month ago

    Pasadena, United States HealthRIGHT 360 Full time

    HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment. Our Outpatient services specialize in treatment mental health and substance use disorders with treatment and skills groups,...

  • Case Manager I

    3 weeks ago

    Pasadena, United States HealthRIGHT 360 Full time

    HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment. Our Outpatient services specialize in treatment mental health and substance use disorders with treatment and skills groups,...

  • Case Manager

    4 days ago

    Pasadena, United States Clearview Treatment Programs Full time

    **Why You Will Love Working With Us!** At Clearview Outpatient, we are a dynamic, dedicated, and growing team of professionals deeply passionate about providing evidence-based and personalized clinical care for behavioral health conditions. Our team’s foundation is client centered care and clinical excellence through our 5-star service commitment -...