Care Manager Assistant

JOB PURPOSE\:

The Care Manager Assistant will provide support to assigned facilities to ensure communication and authorization of medically necessary services provided in the post-acute setting with oversight from Department Manager, RN Case Manager or LPN Care Manager. In addition, may be asked to provide a wide range of administrative and clerical support to the Care Management Department.

KEY RESPONSIBILITIES\:

The Care Management Assistant will provide support to assigned facilities to ensure communication and authorization of medically necessary services provided in the post-acute setting with oversight and support from Department Manager, RN Case Manager and LPN Care Manager.

KNOWLEDGE, SKILLS, ABILITIES\:

• Reasonable demonstration of the ability to understand CMS and Commercial Insurance requirements to ensure compliance with regulations and standards.

• Must have basic knowledgeable of medical necessity review guidelines for commercial, Medicare, and Medicaid insurance products.

• Demonstrates the ability to communicate effectively via phone and email with our internal and external customers.

• Strong organization and ability to multitask is essential to success in this role.

• Identifies and escalates issues that affect the managed care process from a compliance and/or reimbursement standpoint.

• Escalates all cases that requires the assistance/approval of a Department Manager, RN Case Manager or LPN Care Manager, for example single case agreements.

• Must be proficient in the use of computer applications for daily use

• Must be a self-starter and be able to work independently

• Highly proficient in Microsoft Word, Intermediate Excel and Outlook required