Bilingual Case Manager Assistant - Healthcare Support

MedWatch; United States; Hybrid; USD 32,000 - 37,000; Full time

Job summary

MedWatch is seeking a Case Manager Assistant to support the RN Case Manager in coordinating care, reviewing treatment plans for medical necessity, and communicating with health care teams. Fluency in English and Spanish is required to effectively service patients and families.

This role involves documenting actions in the case management system, coordinating with payers, providers, and caregivers, and ensuring adherence to care plans and company policies in a dynamic healthcare environment.

Qualifications

• Active LPN or Medical Assistant certification preferred.
• 5 years of varied clinical experience preferred, or 3 years in a specialty field.
• Must speak fluent English and Spanish with strong reading and writing abilities in each language.

Responsibilities

• Assist RN Case Manager with case management tasks under supervision.
• Review medical data to update Case Management plan and coordinate with providers, payers, patient and caregiver.
• Contact payer offices to understand benefit constraints affecting the plan of action.
• Contact medical care providers and equipment vendors to verify medical necessity.
• Arrange care according to physician orders and patient needs.
• Explore alternative treatment options and provide cost-benefit analyses to payers as needed.
• Maintain patient case files in the computer system and generate timely reports.
• Maintain billing records in the system and keep in touch with providers and patients across care continuum.
• Negotiate with providers to maximize medical benefits and make referrals as appropriate.
• Adhere to policies, participate in Quality Management Program, and be adaptable to changing duties.

Skills

Bilingual English/Spanish

Verbal and written communication

Organizational skills

Time management

Problem solving

Diplomacy

Computer skills

MS Office (Word, Excel, PowerPoint)

Education

LPN

Medical Assistant Certification

Tools

MS Office Suite

Job description

MedWatch is seeking a Case Manager Assistant to support the RN Case Manager in coordinating care, reviewing treatment plans for medical necessity, and communicating with health care teams. Fluency in English and Spanish is required to effectively service patients and families.

This role involves documenting actions in the case management system, coordinating with payers, providers, and caregivers, and ensuring adherence to care plans and company policies in a dynamic healthcare environment.