Case Management AssistantChandler, Arizona

Dignity Health East Valley Rehabilitation Hospital is a joint venture operation and free-standing Post-Acute Inpatient Rehabilitation Hospital between Dignity Health and Kindred Healthcare.  Our two-story, 58,000-square-foot facility includes a stroke unit, therapy gym and 50 beds to serve patients recovering from significant neurological injury, illness and trauma and similar medical conditions.

JOB SUMMARY:

Under the supervision of the Lead Case Manager, or Director of Quality,thisrolecompletesvariousduties to enhance the efficiencyof the CaseManagementDepartment, as well as support the dailyfunctionsofthecasemanagers.Thisroleassistsinsecuringarrangements for the dischargetransitionandpost-acuteservices. While monitoring the revenuecycle process related to insurancecertifications,insuranceverification,peer-to-peercompletion,anddenial/appealtracking,thispositionserves as a liaisonbetween the CaseManagementDepartment,payers,andadditionalentities.

ESSENTIAL FUNCTIONS:

• Providesassistanceto the case managementstaff,includingbutnotlimitedto,creatingandsendingreferralpackets,organizingadmissionanddischargepatientrecords,makingphonecalls,obtainingsignatures,oranyother assistanceneededdetermined by the CM team.
• Assiststhe casemanagement teaminschedulingfamilyconferences.
• Assiststhe case managementteam by makingnecessaryarrangementsforpost-dischargefollow up care.
• Functionsas the pointofcontactandliaison for the hospitalCaseManagementDepartmentstaff regardingclinical insurancereviewcompletionand/orissues.
• Forwardsthe necessarypatientclinicalinformation for alladmission,concurrent,andretrospectiveinsurance reviews to payers for the completionof medical necessityreviews.
• Monitors,follow-up,documents,andtrackspayerresponses/requestsofcompletedclinicalreviews,includingapprovals,appeals,anddenials,andcommunicatestheseto the appropriatepersonnel[hospitalstaff,physician,DCM,CaseManager,ClinicalDenialManagement,andCentralizedBusinessOffice(CBO)].
• Monitorsandtracksthe total hospitalcertifieddays of the patient for payers(commercial,managedcare,andMedicaid)andcommunicatesmissingcertifications to the Lead CM/DQ and Case Manager.
• Organizesandprepares the necessaryclerical elements for the weeklyInterdisciplinaryTeamMeeting to functiontimelyandefficiently.
• Enter DME needs per order sheet specifications.
• Prepare Discharge IMM for delivery.
• Deliver Advance Directive packets.
• Assist with Rehabtracker sign ups.
• Abilityto maintainconfidentiality of allpatient and/or employeeinformation to assurepatientand/or employeerights areprotected.
• Abilityto interface on alllevels of the organization by demonstratingexcellentinterpersonalskills.
• Abilityto communicateeffectively,both in writing andverbally.
• Abilityto workcooperativelyandcollaboratively as a memberof a team.
• Abilityto workunderstressand to respondquicklyinemergencysituations.
• Musthave good and regularattendance.
• Performsother relateddutiesas assigned.

• College degree in healthcare related field preferred
• LPN or social work degree preferred but not required
• Minimum of 1 year hospital or post-acute healthcare experience with preference in case management or clinical department.  Proficient with WORD and EXCEL software, keyboard typing, and general office equipment.