Case Management Extender - Children's Hospital

General Description: The Case Management Extender (CME) provides non-licensed, clerical and administrative support to the RN and SW Case Managers to facilitate and execute discharge plans and other related case management activities as needed. Duties include but are not limited to, calling or faxing information for patient care transitions, including SNF, Home Healthcare, Assisted Living, Outpatient Treatment Centers, etc. Assist with locating appropriate facilities for placement of patients moving to another level of care; facilitation of the transfer to alternate care facilities including arranging transport, facilitating referrals for home care services, and providing general administrative support; assist licensed case managers with regulatory requirements; scheduling post-discharge physician appointments.

Essential Responsibilities:

• Assists RN/SW Case Manager in arranging post-discharge needs
• Assist RN/SW Case Manager by communicating with alternate level of care liaisons to identify an accepting facility and to establish a time line for transfer
• Arrange and/or assist with referrals for home care services
• Ascertain availability of and make timely transportation arrangements
• Arrange delivery of Medical equipment as determine by hospital policy and physician order
• Schedule post-discharge appointments with providers such as PCP, Therapy, Specialist, diagnostic testing as needed
• Maintain patient confidentiality of all communications and documents as required by hospital policy and as regulated by HIPPA
• Enters data into multiple systems and submits appropriate information in a timely fashion to facilitate notification for approval transition of care, i.e. PASRR, medication prior authorizations, etc.
• Issues CMS regulatory letters (MOON, HINN, IMFM, etc,) that have been prepared and delegated by the licensed case manager. Documents issuance of letter in the EMR
• Responds to inquiries, maintains and revises record keeping and filing systems; classifies, sorts, and files correspondence, articles, records, and other documents.

General Responsibilities

• Performs other related duties and special projects as assigned.

Minimum Qualifications:

Education: High school diploma or GED required. Associate's Degree or Bachelor's Degree in medical related field or Medical Assistant Certification preferred.

Experience: Three (3) years of experience required. Three (3) - Five (5) years of healthcare experience with clinical applications, electronic medical record (EMR) such as Epic preferred.

Licensure/Certifications/Registrations Required: None

Knowledge, Skills and Abilities:

• Working knowledge of medical systems and medical terminology or complete department approved training within three (3) months of hire
• Knowledge of CMS regulations, payment systems, post-acute care requirements or acquisition within 3 months of hire
• Knowledge of third party payer issues concerning reimbursement and regulatory perimeters or acquisition within 3 months of hire
• In-depth understanding of typical insurance benefit plans regarding coverage or acquisition within 3 months of hire
• Must be proficient with basic computer skills (word processing, excel spreadsheet, electronic fax
• Excellent typing skills
• Ability to work independently, manage time and prioritize patient needs
• Able to work some weekends and holidays
• Able to adapt to frequent changes in direction
• Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers
• Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
• Able to work in a dynamic, fast-paced team environment and to promote team concepts
• Excellent verbal and written communication skills
• Excellent interpersonal skills and ability to maintain composure in difficult situations