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Job ID: 6046
Location: Raleigh, NC
Facility/Division: UNC REX Healthcare
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 30,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
The Care Management Assistant facilitates arrangements for post-acute services for patient and coordinates requested services for post-discharge.
1. Assist in Facilitating Discharge Planning - Assists Care Management team with administrative support in arranging for discharge of patients including but not limited to durable medical equipment, Home Health, facility referrals and transfers, transportation, and infusions. Reviews work list for referrals throughout the day. Completes all appropriate documentation for routine referrals and prepares documents for post-acute services. Documents all discharge planning activities and communications according to department standard.
2. Assist in Utilization Management Process - Provides information required to insurance companies as requested by Utilization Manager or Care Manager or as per policy. Communicates and documents authorizations. Communicates with Care Manager and Utilization Manager for additional clarification as needed. Determines benefits for post-acute care. Completes follow-up on post-acute care authorization. Escalates potential barriers to discharge to the Care manager as identified. Follows escalation process to department leadership. Collaborates with Care Manager, Social Worker, and/or utilizes estimated discharge report to track discharges. As assigned, administers second Important Message from Medicare (IMM) within two days of discharge. Documents second IMM was administered.
3. FL2 for Long Term Care and Pre-Admission Screening and Resident Review (PASRR) - Completes identified sections of documents as requested by Care Manager and/or Social Worker. Sends completed forms from Care Manager and Social Worker to the state for review. Monitors status. Documents delivery/completion and notifies Care Manager and Social Worker.
4. Other Duties - Assists with other duties as assigned by Care Management leadership. Supports Care Managers, Social Workers, and Utilization Managers as needed. Identifies Avoidable Delays and notifies Care Manager and/or Social Worker of delay and root cause. Completes and transmits other documents as needed.
5. Prioritize Daily Activities - Participates in daily Care Management Touchpoint with Care Managers, Social Workers, and Utilization Managers. Discusses referred cases, including, patient status, barriers to discharge, payer communication, escalations and support needs. Reviews insurance coverage updates on all appropriate patients, as assigned. Regularly evaluates work list and re-prioritizes items for the day. Reviews patient census for each service Care Management team, prioritizing communication needs. Reviews discharge planning priorities.
● High School diploma or GED
● No licensure or certification required.
Professional Experience Requirements:
● Three (3) years of health care experience.
Knowledge/Skills/and Abilities Requirements:
Legal Employer: NCHEALTH
Entity: UNC REX Healthcare
Organization Unit: Rex Case Management Services
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Raleigh
Exempt From Overtime: Exempt: No
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.