Population Health Case Management Assistant I Bilingual I

2 months ago

Bakersfield, United States KHS Full time

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).

KHS reasonably expects to pay starting compensation for the position of Population Health Case Management Assistant I Bilingual I in the range of $19.56 - $25.64 hourly.

Our Mission.. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

Definition

Under the general supervision of the PHM Manager of Case Management, the Case Management Assistant will support the Case Management staff in all activities related to case management and care coordination within the department. The Case Management Assistant will help members navigate the healthcare system and obtain the best care in the most appropriate setting at the right time.

Distinguishing Characteristics

This position will provide administrative support to the Case Management area of KHS, a licensed health maintenance organization (HMO). Incumbents are expected to have an intermediate level of medical knowledge, computer skills, and experience with Microsoft Office suite of products, and ability to work semi-independently under general direction. This position involves frequent communication with members, caregivers, medical providers and KHS staff telephonically, electronically and in-person.

Essential Functions

  • Makes reminder calls to members as assigned by the RN Case Managers. Included but not limited to office visit reminder calls, preventive care and screening calls, and follow up calls after office visits.
  • Follow identified processes for members enrolled in Basic and Complex Case Management and for those in Special Programs.
  • Investigates pharmaceutical utilization as requested.
  • Investigates community and social resources for members as directed.
  • Act as liaison to KHS members, community providers, and employees to the CM clinical staff.
  • Supports the RN Case Managers by assisting in implementing members' Care plans.
  • Responsible for communicating Care Plans to the members' primary care practitioners.
  • Assists with transportation coordination.
  • Mails letters and educational materials as requested by the RN Case Managers.
  • Maintains system databases as needed for reporting and tracking.
  • Assists RN Case Managers in scheduling assessment calls.
  • Benefits interpretation to include coordination of care for medically necessary services that are not covered under the KHS Plan (e.g. CCS, Long Term Care, and State Waiver Programs.)


Other Functions
  • Performs other job-related duties as assigned.
  • Adheres to all company policies and procedures relative to employment and job responsibilities.
  • Adheres to KHS's Code of Ethics and Business Conduct and all company policies; e.g., confidentiality, attendance, safety/security, use of equipment and technology, appearance and demeanor.
  • Regular Predictable Attendance


Employment Standards

Education: High School Diploma from an accredited school or equivalent. Associates degree preferred. **Medical Assistant Certificate (MA) preferred.

Experience: One (1) year of experience in a managed care setting preferred. Two (2) years' experience of data entry and computer skills. Proficient in ICD-9, ICD-10, and CPT coding procedures; medical terminology.

** Typing Certificate 30 wpm required

** Bilingual Spanish/English (Tier I) Certificate required

Knowledge of: Medicaid benefits, Microsoft Office products.

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

Other details
  • Pay Type Hourly
  • Min Hiring Rate $19.56
  • Max Hiring Rate $25.64
  • Telecommute % 0
  • Required Education High School


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