Case Manager Assistant Full Time 40 hours at Bristol Health · Bristol

At Bristol Hospital and Health Care, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet ® and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Hospital and Health Care your choice.

Job Summary

The Discharge Planning Associate (DPA) supports the Case Management department by acting as a communication link between the hospital staff and outside providers and payers. The DPA completes requests and notifies the CM staff when authorizations are delayed or denied so appropriate action can be taken. The DPA provides clerical support to the department manager in tracking and compiling performance statistics as directed. The right candidate also acts as a liaison between Case Management, HIM, compliance, patient access, and financial services.

We offer a comprehensive benefits package designed to support the health, financial well-being, and work-life balance of our employees and their families. Eligible team members have access to medical, dental, and vision insurance, paid time off (PTO) and paid leave, a 403(b) retirement savings plan with company matching, company-paid life insurance, and an array of additional perks including employee assistance and wellness programs. (Exact eligibility and coverage details vary by role and employment status.)

Essential job functions and responsibilities:

• Partners with other Case Management Department staff members in the execution of the discharge plan by:

  • Uploading for faxing Patient referrals for outside reviewers and assists them as needed.
  • Faxing, mailing or electronic submission of preadmission, transfer/discharge clinical and other relevant information as directed by the CM/SW.
  • Arranging transportation for patients going to rehabs, SNF’s or Nursing Homes. Obtains approval from payers and providers.

• Support department functions to secure payment by:

  • Notifying CM when clinical information is requested.
  • Distributing denials to the appropriate case manager for response. Notifies the Case Management Director of approvals, denials, and appeals.
  • Enters authorization and denial information in our tracking sheets and the Medical Record.

• Works collaboratively with Case Management team members in achieving compliance with Federal and State regulations by:

  • Assists CM/SW by distributing Medicare required notices.
  • Notifies the CMRN when patients/families have questions concerning the Medicare Important Message (IM), Medicare Outpatient Observation Notice (MOON) or level of care implications.
  • Tracks and reports compliance with distribution of required notices.

• Supports the department manager by performing clerical function including:

  • Schedules meetings, invites participants and tracks minutes as directed.
  • Maintaining an accurate staff schedule and communicating it to the team.
  • Maintaining and reordering office supplies and equipment.
  • Recording & tracking pertinent information and statistics for the department and UM personnel such as issuances of ABNs, CC44 and HINNs.
  • Complies and tracks audit requests as requested (avoidable day).
  • Relay information/questions appropriately.
  • Performs other duties and special projects as assigned

Initiative / Judgement

• Performs duties independently with minimal supervision.
• Coordinates work load to achieve a high level of productivity and efficiency.
• Offers suggestions to improve workflow.
• Demonstrates good judgment and analytical ability.
• Escalates issues and barriers to department leadership.

Customer and Staff Relations

• Demonstrates a good rapport and works to establish cooperative working relationships with all members of the Case Management department, Bristol Hospital, and provider partners.
• Fosters positive interpersonal relationships and professional image by adhering to customer service standards with internal and external contacts, whether in person, by phone, or electronically.
• Consistently demonstrates ability to tactfully handle difficult situations, maintaining a calm demeanor.
• Demonstrates thorough knowledge of Hospital and Departmental Procedures and Policies.
• Maintains confidentiality and complies with professional ethics according to professional and departmental standards.

Qualifications

Educational / Minimum Requirements:

• High School Diploma and/or associate degree preferred.
• Work experience in a healthcare setting is preferred.
• Working knowledge of medical terminology.
• Strong computer and clerical skills.

State/Federal Mandated Licensure or Certification Requirements:

• None specified

Bristol Hospital Mandated Educational Requirements:

• General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

• None specified

Physical Requirements:

• None specified

Work Environment:

• None specified

Cognitive Requirements:

• None specified

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.