Care Management Assistant

WVU Medicine; Wheeling (WV); On-site; USD 34,000 - 42,000; Full time

Job summary

WVU Medicine Wheeling Hospital in Wheeling, WV seeks an Administrative Support Specialist for the Care Management Team. This role supports day-to-day operations, discharge planning, and payer communications to secure authorizations and coordinate post-acute services.

Key duties include coordinating with payers, updating EMR, and providing clerical support while maintaining confidentiality in a fast-paced health system environment in West Virginia.

Qualifications

• High school diploma or equivalent.
• Two years administrative experience.
• Experience in a healthcare setting preferred.

Responsibilities

• Greet visitors and screen calls; route to Care Management.
• Communicate clinical information with payers to obtain authorizations and document in EMR.
• Assist with discharge planning and linkage to post-acute providers.
• Provide payer feedback to supervisor to adjust patient plans.
• Coordinate placement and research providers for post-discharge care.
• Maintain confidentiality and perform clerical tasks.

Skills

Communication skills

Team collaboration

Computer literacy

Education

Associates degree or higher

Tools

Electronic Medical Records (EMR)

Job description

Welcome! We’re excited you’re considering an opportunity with us! Below, you’ll find other important information about this position.

This position provides support to the Care Management Team to ensure that the day to day operational functions of the department are met in a timely manner. This position includes collaboration with third party payers as well as post-acute providers. This position will also be responsible for timely and appropriate documentation within the electronic Care Management System.

MINIMUM QUALIFICATIONS:

• 1. High School diploma or equivalent.
• 1. Two (2) years administrative experience.

PREFERRED QUALIFICATIONS:

• 1. Associates or advanced degree.
• 1. Two (2) years’ experience in a health care setting.
• 2. Hospital, home health, or payer relations experience.
• 3. Clerical experience in utilization management, discharge planning or case management.
• 4. One (1) year of ICD9/CPT Coding or Medical Terminology experience.

CORE DUTIES AND RESPONSIBILITIES:

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

• 1. Greets visitors and health care personnel promptly and professionally; screens visitors and telephone calls to determine urgency of contact and to facilitate appropriate routing or referral; representing Care Management in a positive manner.
• 2. Effectively communicates clinical information with payer to obtain authorization for post-acute services/medications and documents interactions in patient’s electronic medical record (EMR) along with timely communication with Care Management staff.
• 3. Participates in discharge planning activities (e.g. contact of post-acute care facilities, other community resources and transportation) as needed to ensure a timely patient discharge and appropriate linkage with post-acute providers
• 4. Provides prompt feedback regarding payer determinations to Supervisor/Care Manager, enabling them to evaluate/redirect the current patient plan of care in order to streamline the delivery of service.
• 5. Function as placement specialist, as required ,to include research for preferred providers for HHC/DME/Acute Rehab/SNF/LTACH placement
• 6. Proactively communicates any change in payer information to Supervisor/Care Manager and documents changes appropriately
• 7. Verify with patient financial counseling that all payment sources have been explored and updated in the patient’s electronic medical record (EMR).
• 8. Participates in reimbursement, certification and authorization related activities (e.g. faxing or copying required information) as required.
• 9. Contacts and coordinates with referral agencies to arrange provision of ordered equipment and associated services when appropriate, as directed by Care Managers.
• 10. Collects copies and transmits pertinent clinical and patient demographic information required to complete arrangements for post-discharge care and/or placement, as directed by the Care Managers.
• 11. Coordinates and arranges transportation and community services, as directed by care managers.
• 12. Provides secretarial and clerical support, including faxing, copying charts, filing, typing and scanning.
• 13. Ensures payer and customer satisfaction through effective communication and positive customer service skills at all times.
• 14. Maintains confidentiality of communications.
• 15. Using independent judgment prioritizes appropriately to ensure efficient utilization of time.
• 16. May serve as back up to the Administrative Assistant for Care Management in their absence.

PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• 1. Prolonged periods of standing or sitting.

WORKING ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• 1. Flexible hours to include weekends and holidays.
• 2. May include some patient interaction.

SKILLS AND ABILITIES:

• 1. Excellent verbal and written communication skills.
• 2. Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
• 3. Basic computer knowledge and ability to operate standard office software.

Additional Job Description:

Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: WH Wheeling Hospital Inc. Cost Center: 403 WH Care Management Address: 1 Medical Park Drive Wheeling West Virginia

Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, and local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

The West Virginia University Health System is West Virginia’s largest health system and largest private employer, providing care to communities across West Virginia, Maryland, Ohio, and Pennsylvania. The integrated academic health system includes 25 hospitals and five institutes, with more than 3,500 licensed beds, 4,000 clinicians, 39,000 employees, and $8.5 billion in annual operating revenues. Anchoring the system in Morgantown, West Virginia, are WVU Hospitals, an 880-bed academic medical center, and the 150-bed WVU Medicine Golisano Children’s Hospital. Together, the Health System’s hospitals, clinics, and specialty programs provide a comprehensive continuum of care, ranging from community-based primary and specialty services to highly complex, quaternary care and post-acute care.