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Care Management Coordinator
1 month ago
Alameda Health System is seeking a skilled Care Management Specialist to join our team. The successful candidate will assist in the Care Management Team with various functions, including census reconciliation, administrative support for care coordination and discharge planning activities, and working with payors.
Key Responsibilities:
Reconcile census and work with Patient Access and the Care Management team to ensure census is correct in the financial and care management systems.
Prepare paperwork and updates encounter information for admissions, discharges, and transfers of patients.
Collaborate with Case Management staff to provide specific clinical information for the purpose of completing initial and concurrent utilization review to ensure certification/approval of in-patient and post-discharge services.
Facilitate, identify, and document all referrals made to contracted facilities, providers, or agencies, and make post-discharge appointments for patients and coordinate transportation.
Manage multiple inquiries and present referrals based on location and services provided, and follow up on active or pending inquiries.
Coordinate with referral sources on bed availability, new products, and services, and maintain a current database of existing and potential referral sources.
Requirements:
High School Diploma or G.E.D.
Three years of experience in a healthcare field or one year in Utilization Management at a Medical Group or Health plan experience, with electronic Health Record (EHR) and Case Management applications, e.g., Midas or 3M.
Preferred Qualifications:
Bachelor's degree in a related field.
Medical Assistant experience.