About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Integrated Care Management Assistant Case Management
Department: Case Management
Hours per pay period: 80
Schedule: Day Shift
Position Summary: Responsible for providing assistance to the RN and SW Care Managers in the coordination of discharge and transition plans, as well as, performing clerical functions to ensure the efficient operation of the ICM department.
Essential Functions and Responsibilities as Assigned:
1. Assists with facilitating discharge planning to expedite a successful transition of care.
2. Assists RN and SW Care Managers with the referral process by collecting and distributing informational brochures/pamphlets that enhance patient/family choice of providers, agencies and other professional health care services.
3. Assists with the coordination post discharge placement and services by making referrals, confirming specific placement and service arrangements, processing, organizing and obtaining insurance verification and/or prior authorization from insurance companies for discharge arrangements.
4. Assists with contacting community resources to coordinate discharged transition plans while using professional tact and diplomacy skills between patients, colleagues and community.
5. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON) completion.
6. Communicates pertinent documentation to nursing and homecare facilities to expedite patient discharges for assigned patients.
7. Assists with contacting community resources to coordinate discharged transition plans while using professional tact and diplomacy skills between patients, colleagues and community.
8. Attends meetings and prepares agendas and minutes.
9. Handles incoming and outgoing office correspondence; answers and directs department phone calls as needed.
10. Performs general office duties including faxing, copying, scanning and filing. Orders department supplies.
11. Tracks and communicates bed availability at area extended care and rehab facilities.
12. Communicates with internal and external customers to answer questions.
13. Troubleshoots problems that arise with office equipment. Notifies leadership of unresolved issues.
14. Performs other related duties as required and directed.
Required
· Associate degree in healthcare-related field
· Two years of clerical experience
· One-year experience in a heath care environment utilizing medical terminology or have completed a college level course in medical terminology
· Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN)
Preferred:
· Bachelor’s degree in coding/medical records/billing or UM
· Two years of case management or utilization review experience
· Three years of recent experience doing third party payer certification
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
