Care Management Tech

Tenet Healthcare; Detroit (MI); On-site; USD 38,000 - 54,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401(k) with employer match

Paid time off

Career development

Health savings accounts

Employee assistance

Employee discounts

Pet insurance

Legal insurance

Accident/critical illness insurance

Long term care

Elder care

Auto/home insurance

Job summary

Tenet Healthcare’s DMC Sinai-Grace Hospital in Detroit seeks a Care Management Tech to support care coordination and utilization management.

Under supervision, you will assist with eligibility, benefit coverage, discharge planning, and interfacing with payers and Patient Financial Services, contributing to smooth patient transitions.

A high school diploma and 1–2 years in outpatient or hospital settings, plus data entry and basic medical terminology knowledge, are preferred.

Qualifications

• High school diploma or equivalent required.
• 1–2 years in outpatient clinic or hospital setting preferred.
• Experience in insurance, medical records, billing or related area desirable.
• Medical Assistant cert, LPN license, or healthcare coursework preferred.
• Basic computer applications experience beneficial.
• Knowledge of medical terminology preferred.

Responsibilities

• Assist Care Management functions under supervision and participate in care coordination activities.
• Communicate with third party payers and other resources to aid in patient disposition.
• Maintain utilization review files and assist with discharge planning and beneficiary communications.
• Enter data into hospital databases; support eligibility checks and benefit verification.
• Support problem resolution with patients, families, and providers to maintain service excellence.

Skills

Interpersonal communication

Written and oral communication

Managed care knowledge

Data entry

Computer systems

Lifting up to 20 lbs

Payer requirements

Multi-tasking

Basic math

Education

High school diploma or equivalent

Medical Assistant certification

LPN license or related coursework

Tools

None

Job description

Job Description - Care Management Tech (2506004272)

Job Description

Care Management Tech - 2506004272

Description

Description :

DMC Sinai-Grace Hospital is committed to providing exceptional patient care in a supportive and collaborative environment. As a member of our team, you will have the opportunity to work with advanced technology and be part of a healthcare community dedicated to making a positive impact on the lives of our patients.

Benefit Statement

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare C dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder C childcare, auto C home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status

Summary Description

Under general supervision and according to established policies and procedures, provides assistance to Care Management functions for the site. Participates as a member of the Care Management Team to facilitate process flow in care coordination activities and transition planning. Communicates with Third Party payers and other community resources to assist in the patient disposition process. Interfaces with Patient Financial Services on issues related to eligibility, benefit coverage, and appropriate provider. Performs input into various databases as appropriate for utilization management, LOS management and Denial Management activities. Audits data input and corrects errors, as needed. Investigates and responds to inquiries related to the authorization process, benefit coverage and general concerns regarding policies and procedures. Maintains necessary utilization review files for all patients in the hospital. Validates discharge dispositions and assists with issuing Medicare Important Message letters prior to discharge. Establishes and maintains effective relationships with physicians and all other staff members, internally and externally. Identifies problems or any dissatisfaction experienced by any customer or referring source and works to resolve them to a high degree of service excellence. Uses positive interpersonal skills to effectively resolve conflict. Promotes a positive customer relations environment. Performs related clerical/secretarial duties as needed.

Qualifications

Qualifications :

• High school diploma or equivalent.
• One to two years related experience in an outpatient clinic or hospital setting, including six to twelve months of data entry experience.
• One to two years work experience in an insurance, medical records, billing or related area desirable.
• Medical Assistant certification, license to practice as a Licensed Practical Nurse (LPN), or college coursework in heath care preferred.
• Additional training in computer applications preferred.
• Working knowledge of medical terminology desired.

Minimum Qualifications

• High school diploma or equivalent.
• One to two years related experience in an outpatient clinic or hospital setting, including six to twelve months of data entry experience.
• One to two years work experience in an insurance, medical records, billing or related area desirable.
• Medical Assistant certification, license to practice as a Licensed Practical Nurse (LPN), or college coursework in heath care preferred.
• Additional training in computer applications preferred.
• Working knowledge of medical terminology desired.

Skills Required

• Interpersonal skills to effectively communicate with third party payers, hospital staff and various other internal/external contacts, and to answer telephone inquiries.
• Written and oral communication skills.
• Knowledge of managed care and referral processes.
• Manual dexterity to type and enter data using the computer.
• Ability to utilize computer systems; computer skills and knowledge of various software packages
• Ability to push, pull and/or lift objects weighing up to 20 lbs.
• Ability to understand and apply various third party payer requirements, verification procedures and benefits.
• Ability to work within a complex environment and handle multiple priorities.
• Mathematical ability to perform basic calculations such as percentages, addition, multiplication, etc.

Facility Description

DMC Sinai-Grace Hospital is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children’s Hospital of Michigan Emergency Department is a verified Level 1 Pediatric Trauma Center and dedicated pediatric burn center. Experts in pediatric critical care, rehabilitation, and neonatal and perinatal medicine provide care for thousands of children every year at Children’s Hospital of Michigan, Children’s Hospital of Michigan - Troy and six ambulatory sites.

EEO Statement

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

Upon receipt of a conditional offer of employment, applicant will be required to undergo a criminal background check.

Tenet participates in the E-Verify and Work Opportunity Tax Credit (WOTC) programs. Follow the links below for additional information.

E-Verify: http://www.uscis.gov/e-verify

WOTC: https://www.doleta.gov/business/incentives/opptax