Care Transitions & Case Management Specialist

Memorial Hermann Health System; Northern (KY); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Memorial Hermann Health System is seeking a Case Management Assistant to support the Case Management team, physicians, and clinical staff. The role includes gathering information, educating patients, and facilitating appropriate care transitions.

Under the Case Management Director, you will help develop patient education programs, liaise with payors and providers, and contribute to performance improvements while ensuring safe transitions from hospital to home.

Qualifications

• Minimum of one year experience in a health care setting.
• Experience working directly with patients, physicians and other caregivers required.
• Experience providing patient education in a clinic or outpatient setting preferred.
• Knowledge of the Medical Home Initiative and ability to work with payors, case managers and others to facilitate resource use.
• Demonstrated superior written and verbal communication skills and ability to manage multiple tasks.

Responsibilities

• Participates in development of patient educational programs.
• Provides information and support to Case Management team for individualized plans of care.
• Acts as liaison between Case Managers and Medical management team for program issues.
• Maintains current knowledge of third-party payor expectations and NCQA Medical Home Standards.
• Tracks denial by type, payor, and appeal outcome; reports denial trends.
• Supports discharge planning and linkage to post-acute providers.

Skills

Word processing

Spreadsheets

Verbal communication

Written communication

Multitasking

Education

Associate degree preferred

Tools

Microsoft Word

Microsoft Excel

Job description

Memorial Hermann Health System is seeking a Case Management Assistant to support the Case Management team, physicians, and clinical staff. The role includes gathering information, educating patients, and facilitating appropriate care transitions.

Under the Case Management Director, you will help develop patient education programs, liaise with payors and providers, and contribute to performance improvements while ensuring safe transitions from hospital to home.