Care Management Resource Coordinator
5 days ago
Department: PCH-MAIN | Case Management
Location: Phoenix
Shift: Mon-Fri, Days, 8am-5pm
Category: Administrative Support
Posting #: 861521
Employee Type: Full-Time
Position Summary
The Care Management Resource Coordinator supports the efforts of Social Work, Case Management and Utilization Management professionals by performing a wide range of administrative duties that promote a positive patient-family experience during hospitalization, facilitate safe and timely discharge of patients, and reduce risk of unfunded services or excessive cost to patients-families. The Resource Coordinator interacts directly with patients and families, other healthcare organizations and suppliers, and third-party payers. This position receives regular supervision of work activities from the Manager, Case Management and/or Manager, Social Services. This position does not supervise any other position.
Position Duties
- Supports Social Work activities
- a) Receives, evaluates and fulfills requests for local transportation vouchers, meal cards and other amenities.
- b) Receives, evaluates and fulfills requests for out-of-area transportation, including air travel and lodging.
- c) Receives, evaluates and facilitates requests for Ronald McDonald House services.
- d) Appropriately escalates requests that do not meet criteria to responsible social worker or manager.
- e) Faxes medical records and other documents, as directed by social workers, to law enforcement agencies, government agencies, and other healthcare organizations.
- f) Assists patients-families to schedule appointments with various agencies.
- g) Assists patients with documents or letters needed for FMLA, border crossing applications, school activity letters, and other social needs related to their care.
- h) Schedules care conferences.
- i) Maintains complete and accurate patient resource materials, including primary care providers by payer source (including free and low-cost clinics), WIC information, housing resources, and other social services. Provides resource information as requested by patients-families, social workers, and care team members.
- j) Obtains car seats.
- k) Answers Social Work phone line and retrieves voice mail messages. Takes appropriate and authorized actions or routes to Social Worker.
- Supports Utilization Management activities
- a) Reviews and organizes materials faxed to department, prepares daily reports and other materials, and distributes/directs to appropriate Utilization Management nurse.
- b) Receives and reviews third-party payer requests for concurrent review and notifications of denied hospital days; routes to appropriate Utilization Management nurse.
- c) Answers Utilization Management/Case Management phone line and retrieves voice mail messages. Takes appropriate and authorized actions or routes to Utilization Management or Case Management nurse.
- d) Scans and uploads into the EMR and/or financial applications authorization and requests for concurrent and retrospective third-party utilization reviews.
- e) Enters authorization information in financial applications.
- f) Maintains reports of denied hospitalizations and hospital days, pending appeals, outcomes of appeals, and reasons for delayed discharges.
- g) Identifies, monitors and communicates trends with third-party payer denials of authorization requests to appropriate manager.
- Supports Case Management activities
- a) Identifies and provides appeal rights letters to in-house Tricare and Medicare patients, and documents in log and the medical record.
- b) Verifies address and other demographic information for purposes of coordinating delivery of home needs and communication with families post-discharge.
- c) Identifies current home care service providers, and documents in the medical record for the Case Manager.
- d) Determines third-party payer coverage/benefits and obtains insurance pre-authorization for home health services, post-discharge medications, rehabilitative therapy, durable medical equipment, medical transportation, and other post-discharge needs.
- e) Facilitates arrangements for post-discharge needs, including scheduling services and coordinating availability of equipment/supplies and medications, under the direction of the Case Manager. Provides patient-family, Case Manager and clinical care team members with timely and accurate status of coordination of services, and documents information in the medical record. Appropriately escalates to responsible Case Manager and other care team members any situation/issue that poses a barrier to providing for complete and timely post-discharge needs.
- f) Monitors and determines bed availability at rehab facilities, other acute care hospitals, long-term care facilities, mental health facilities and other organizations. Determines third-party coverage/benefits and obtains authorization for transfer to other facilities; faxes medical records and coordinates transfer of patient under direction of the Case Manager. Appropriately escalates to responsible Case Manager and other care team members any situation/issue that poses a barrier to on-schedule transfer. Documents status and actions in the medical record.
- g) Coordinates peer-to-peer medical records with third-party payers and PCH providers.
- h) Conducts post-discharge follow-up calls to patients, and appropriately notifies Case Managers when intervention is needed.
- Care Management Department support
- a) Understands and focuses on Hospital Revenue Cycle key performance indicators.
- b) Works collaboratively with team members and performs clerical cross-coverage where
- needed.
- Provides excellent customer service
- a) Responds to emails within 24 hours.
- b) Clear communication skills with all internal and external customers.
- c) Provides excellent service routinely in interactions with all customers, i.e. coworkers, patients, visitors, physicians, volunteers, etc.
- Performs miscellaneous job related duties as requested.
Phoenix Children's Mission, Vision, & Values
Mission
To advance hope, healing and the best healthcare for children and their families
Vision
Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.
We realize this vision by:
- Offering the most comprehensive care across ages, communities and specialties
- Investing in innovative research, including emerging treatments, tools and technologies
- Advancing education and training to shape the next generation of clinical leaders
- Advocating for the health and well-being of children and families
- We place children and families at the center of all we do
- We deliver exceptional care, every day and in every way
- We collaborate with colleagues, partners and communities to amplify our impact
- We set the standards of pediatric healthcare today, and innovate for the future
- We are accountable for making the highest quality care accessible and affordable
-
Care Management Resource Coordinator
2 weeks ago
Phoenix, Arizona, United States Phoenix Children's Hospital Full timeAbout the RoleWe are seeking a highly skilled and compassionate Care Management Resource Coordinator to join our team at Phoenix Children's Hospital. As a key member of our Care Management Department, you will play a vital role in supporting the efforts of Social Work, Case Management, and Utilization Management professionals.Key ResponsibilitiesSupport...
-
Care Management Resource Coordinator
4 months ago
Phoenix, United States Phoenix Children's Hospital Full timePosition Details Department: PCH-MAIN | Case Management Category: Administrative Support Location: Phoenix Employee Type: Regular Posting #: 835371 Posted On: 5/7/2024 Position Summary The Care Management Resource Coordinator supports the efforts of Social Work, Case Management and Utilization Management professionals by performing a wide range of...
-
Care Management Resource Coordinator
4 days ago
Phoenix, Arizona, United States Phoenix Children's Hospital Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Care Management Resource Coordinator to join our team at Phoenix Children's Hospital. As a key member of our Care Management Department, you will play a vital role in supporting the efforts of Social Work, Case Management, and Utilization Management professionals.Key ResponsibilitiesSupport...
-
Care Management Resource Coordinator
1 week ago
Phoenix, Arizona, United States Phoenix Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Care Management Resource Coordinator to support the efforts of Social Work, Case Management, and Utilization Management professionals at Phoenix Children's Hospital.Key ResponsibilitiesSupport Social Work activities by receiving, evaluating, and fulfilling requests for local transportation vouchers, meal cards, and...
-
Care Management Resource Coordinator
1 week ago
Phoenix, Arizona, United States Phoenix Children's Hospital Full timeJob SummaryWe are seeking a highly skilled and compassionate Care Management Resource Coordinator to join our team at Phoenix Children's Hospital. As a key member of our Care Management Department, you will play a vital role in supporting the efforts of Social Work, Case Management, and Utilization Management professionals.Key ResponsibilitiesSupport Social...
-
Care Management Resource Coordinator
3 weeks ago
Phoenix, Arizona, United States Phoenix Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Care Management Resource Coordinator to support the efforts of our Social Work, Case Management, and Utilization Management teams. This role will play a critical part in promoting a positive patient-family experience during hospitalization, facilitating safe and timely discharge of patients, and reducing risk of...
-
Care Management Resource Coordinator
3 weeks ago
Phoenix, Arizona, United States Phoenix Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Care Management Resource Coordinator to support the efforts of our Social Work, Case Management, and Utilization Management teams. This role will play a critical part in promoting a positive patient-family experience during hospitalization, facilitating safe and timely discharge of patients, and reducing risk of...
-
Human Resources Coordinator
3 days ago
Phoenix, Arizona, United States Banner Rehabilitation Hospital - East Full timeJob Title: Human Resources CoordinatorBanner Rehabilitation Hospital - East is seeking a highly skilled Human Resources Coordinator to join our team. As a key member of our HR department, you will be responsible for providing daily management of the Human Resources function, performing confidential and administrative services, and serving as a primary...
-
Human Resources Generalist
3 weeks ago
Phoenix, Arizona, United States Fellowship Square, Christian Care Management, Inc. Full timeAbout the RoleFellowship Square, Christian Care Management, Inc. is seeking a highly skilled Human Resources Generalist to join our team. As a key member of our HR department, you will be responsible for managing the full cycle of recruitment and talent acquisition, ensuring that we attract and retain top talent to support our organization's mission.Key...
-
Coordinator - Care Management
2 weeks ago
Phoenix, United States Optima Medical Full timeAbout Optima Optima Medical is an Arizona-based medical group consisting of 22 locations and 90 medical providers, who care for more than 120,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nations top...
-
Human Resources Coordinator
6 days ago
Phoenix, Arizona, United States GardaWorld Full timeJob Title: Human Resources CoordinatorGardaWorld is seeking a highly organized and detail-oriented Human Resources Coordinator to join our team in Phoenix, AZ.Job SummaryThe Human Resources Coordinator will be responsible for managing all administrative human resource functions for the GardaWorld Security Services branch team. This includes candidate...
-
Logistics Coordinator
2 weeks ago
Phoenix, Arizona, United States Nesco Resource Full timeJob SummaryNesco Resource is seeking a highly organized and detail-oriented Logistics Clerk to join our team. As a Logistics Clerk, you will be responsible for coordinating the organization's daily logistical operations, including inventory control, order fulfillment, and distribution.Key Responsibilities:Inventory Management: Coordinate the organization's...
-
RN Chronic Care Manager
4 weeks ago
Phoenix, United States Centric Care Management Inc Part time $35 - $40Job DescriptionJob DescriptionAre you passionate about delivering high-quality patient care and ensuring positive outcomes for individuals with chronic conditions? Do you excel in coordinating care to eliminate gaps and prevent readmissions? If so, we have an exciting opportunity for you to make a difference as a Chronic Care Manager!As a Chronic Care...
-
Human Resources Coordinator
19 hours ago
Phoenix, Arizona, United States U.S. District Court, District of Arizona Full timeJob SummaryWe are seeking a highly organized and detail-oriented Human Resources Assistant to join our team at the U.S. District Court, District of Arizona. As a key member of our Consolidated Human Resources Division, you will provide critical support to our HR Director and other team members in the Tucson location.Key ResponsibilitiesProcess a variety of...
-
Human Resources Generalist
3 weeks ago
Phoenix, Arizona, United States Fellowship Square, Christian Care Management, Inc. Full timeAbout the RoleFellowship Square, Christian Care Management, Inc. is seeking a highly skilled Human Resources Coordinator to join our team. As a key member of our HR department, you will be responsible for managing the recruitment and onboarding process for new hires, ensuring a seamless transition into our organization.Key ResponsibilitiesRecruitment and...
-
RN Care Manager
3 weeks ago
Phoenix, Arizona, United States Centric Care Management Inc Full timeJob Description**Chronic Care Manager Role at Centric Care Management Inc**We are seeking a skilled and compassionate Registered Nurse to join our team as a Chronic Care Manager. As a key member of our care coordination team, you will play a vital role in delivering high-quality patient care and ensuring positive outcomes for individuals with chronic...
-
Human Resources Coordinator
2 months ago
Phoenix, United States GardaWorld Full timeJob DescriptionJOB SNAPSHOTJob Title: Human Resources Coordinator Location: Phoenix, AZ Environment: Corporate Office Pay Rate: $45,760.00 Included Benefits/Perks: Medical, Dental, Vision, 401K, PTOWho is GardaWorld? GardaWorld is the world's largest privately-owned security services company. We protect our clients' staff and assets, wherever they are in the...
-
Logistics Coordinator
1 week ago
Phoenix, Arizona, United States Nesco Resource Full timeJob SummaryWe are seeking a highly organized and detail-oriented Logistics Clerk to join our team at Nesco Resource.Key ResponsibilitiesCoordinate daily logistical operations, including inventory control, order fulfillment, and distribution.Organize warehousing for goods and ensure efficient storage and retrieval.Review inventory to ensure accurate product...
-
HR Coordinator
3 weeks ago
Phoenix, United States Fellowship Square, Christian Care Management, Inc. Full timeOverview: Our organization is seeking a qualified Human Resources Coordinator with a focus on recruitment. The Human Resources Coordinator is responsible for hiring top talent across various departments and maintaining employee records. This role requires a mix of interpersonal skills, organizational abilities, and a passion for fostering a diverse and...
-
RN Care Manager
3 weeks ago
Phoenix, Arizona, United States Centric Care Management Inc Full timeJob DescriptionCentric Care Management Inc is seeking a skilled RN Chronic Care Manager to join our team. As a Chronic Care Manager, you will play a vital role in providing high-quality patient care and ensuring positive outcomes for individuals with chronic conditions.Key Responsibilities:Conduct comprehensive assessments of patients with chronic conditions...
