Case Management Specialist ARRMC (Case Management)

Additional Position Details: FTE: 1.000000 | Full Time | Variable Hours/Variable Days

Position Summary

The Case Management Specialist functions as a member of The Resource Management team. They utilize communication, organizational, and problem-solving skills to carry out the post-hospital care plans and interventions, utilization review and denials management activities as defined by the RN Discharge Coordinator and RN Utilization Reviewer. They assume a pivotal role with the patient care team to achieve optimal clinical and resource outcomes.

Key Responsibilities

• Applies knowledge and skills necessary to effectively implement the post-acute care plan and utilization review activities as defined by the RN.
• Manages incoming payor correspondence, by fax or phone, including documentation of hospital authorizations and denials from the payors, indexing correspondence to the medical record, and faxing additional documentation as needed.
• Complies with all Asante , departmental policies and procedures, and regulatory requirements related to discharge planning and utilization review.
  
  

Position Qualifications

Experience

• 3 years of experience in administrative functions in care coordination and/or utilization management in healthcare settings is required.
• Experience with Microsoft Word and Excel required and experience with EPIC highly desired.
• Current understanding of CMS regulations related to hospital discharge requirements is preferred.
  
  

Education

• Associates degree in business, healthcare administration or related field or equivalent is preferred.
  
  

Total Rewards Package

• Earn a competitive and progressive salary
• Benefit from health plans that are focused on health and wellness including medical, dental, vision and wellness beginning within 30 days of hire
• On-call employees receive an additional 15% for flexibility
• Plan for your future with a retirement package that includes up to 6% employer contribution
• Experience a healthy work-life balance with our generous earned time off (ETO)
• Continue to enhance your education through our tuition reimbursement and tuition repayment plans
  
  

At Asante, we are guided by our values below. Explore Asante more by visiting www.asante.org/careers

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.