Care Management Associate - Case management - Days - FT (include weekends) - Irvine

UCI Health; Orange (CA); On-site; USD 52,000 - 70,000; Full time

Job summary

UCI Health coordinates patient care in collaboration with the case manager, patient/family, healthcare team and payors for episodes of illness or treatment.

This role supports discharge planning, verification and authorization of insurance, referrals, and follow-up appointments, documenting all activities in required systems to ensure seamless care delivery.

Qualifications

• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties.
• Must demonstrate general understanding of medical terminology
• Must demonstrate customer service skills appropriate to the job
• Minimum of 2 years experience in a hospital or medical office setting
• Extensive and demonstrated knowledge of Government and Commercial Insurance Plans
• Experience with registration and/or billings computer software programs
• Excellent written and verbal communication skills in English
• Demonstrated knowledge and understanding of Managed Care plans
• Demonstrated experience with referral authorization process
• Demonstrated experience with MS Office (Word, Excel, Outlook)
• Demonstrated ability to utilize payer and government websites to access and interpret health plan benefit packages and make determinations
• Ability to work weekends, holidays, and evenings
• Ability to maintain a work pace appropriate to the workload
• Ability to interpret and understand various medical insurance plans and make accurate determinations regarding coverage
• Ability to establish and maintain effective working relationships across the Health System

Responsibilities

• Coordinate care services for assigned patients for an episode of illness or treatment as defined by the case manager.
• Assist with discharge planning, insurance verification & authorization, obtaining resources, sending referrals, and follow-up medical appointments.
• Document activities in required computer systems.

Skills

Customer service

MS Office

Tools

MS Office (Word, Excel, Outlook)

Job description

Who We Are

UCI Health is one of California’s largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.

Who We Are

UCI Health is one of California’s largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.

As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary

In collaboration with the case manager, patient/family, healthcare team and payors, incumbent coordinates the care services for assigned patients for an episode of illness or treatment as defined by the case manager. Promotes the effective utilization of resources using current knowledge and awareness of community resources to achieve optimal care. This includes assisting with discharge planning, insurance verification & authorization, obtaining necessary resources, sending referrals, making follow up medical appointments, and appropriate documentation of activities in all required computer systems.

Required Qualifications

What It Takes to be Successful

• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties
• Must demonstrate general understanding of medical terminology
• Must demonstrate customer service skills appropriate to the job
• Minimum of 2 years experience in a hospital or medical office setting
• Extensive and demonstrated knowledge of Government and Commercial Insurance Plans
• Experience with registration and/or billings computer software programs
• Excellent written and verbal communication skills in English
• Demonstrated knowledge and understanding of Managed Care plans
• Demonstrated experience with referral authorization process
• Demonstrated experience with MS Office (Word, Excel, Outlook)
• Demonstrated ability to utilize payer and government websites to access and interpret health plan benefit packages and make determinations
• Ability to work weekends, holidays, and evenings
• Ability to maintain a work pace appropriate to the workload
• Ability to interpret and understand various medical insurance plans and make accurate determinations regarding coverage
• Ability to establish and maintain effective working relationships across the Health System

Preferred Qualifications

• Knowledge of UCI policies and procedures

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions Of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment
• Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at [e-mail] or at [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization