Case Analyst - HMHI Downtown Clinic

University of Utah Health; Salt Lake City (UT); On-site; USD 60,000 - 80,000; Full time

Job summary

University of Utah Health is seeking a qualified care coordination professional to support patients and families. The role coordinates services under the attending physician and clinical case management, ensuring clear communication among patients, families, payers, and the health care team.

The incumbent helps develop and implement care plans, advises on financial resources, and collaborates with referring physicians and community agencies to improve access and outcomes.

Qualifications

• Bachelor's degree in a clinical area, health care administration, or related field.
• Two years of experience in case management with third party payers.
• Current RQI Healthcare Provider eCredential or ability to obtain within 30 days.
• Additional license requirements as determined by the department.

Responsibilities

• Act as patient advocate to facilitate effective communication and appropriate treatment.
• Orient patients to the Health Sciences Center program.
• Collaborate with health care team to develop and implement a care plan.
• Advise patients and families on financial matters and assist with accessing resources.
• Help establish and maintain relationships with referring physicians, payers and community agencies.
• Facilitate timely evaluations, reports, and team conferences.
• Maintain contact with patient families to involve them in progress.
• Coordinate with payers and prepare discharge planning reports.
• Ensure payer representation in staffing conferences when requested.

Skills

Communication skills

Organizational skills

Lifespan development knowledge

Education

Bachelor's degree in clinical area / related field

Job description

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

This position coordinates services as directed by the attending physician, referring physician and clinical case manager. The incumbent oversees the delivery of individualized services to patients and families and is responsible for facilitating open and accurate communication among patients, their families, referral providers, payers and the overall health care team.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

Essential Functions

• Functions as the patient advocate to facilitate effective communication and appropriate treatment.
• Orients the patient to the Health Sciences Center program.
• Works with the health care team and patient in the development and implementation of a care plan.
• Advises patients and families regarding financial matters and assists social workers and case managers in accessing financial and community resources.
• Assists in establishing and maintaining good relationships with referring physicians, third party payers and community agencies.
• Facilitates the involvement of team members, timely completion of evaluations and reports, and the scheduling of team conferences.
• Maintains contact with patient families in order to facilitate active involvement and knowledge of patient progress.
• Contacts payers and submits reports regarding the patient's initial assessment, expected outcome, expected cost and then recommendeds a discharge plan.
• Ensures the payer is represented in staffing conferences when requested.

Knowledge / Skills / Abilities

• Ability to perform the essential functions of the job as outlined above.
• Demonstrated organizational, human relations and effective communication skills.
• Ability to provide care appropriate to the population served.
• Demonstrated knowledge of the principles of life span growth and development.
• Ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.

Required

Qualifications

• Bachelor's degree in a clinical area, health care administration, a related field, or equivalency.
• Two years of experience in case management activities with third party payers.

Licenses Required

• Current RQI Healthcare Provider eCredential through the University of Utah Health RQI system. The eCredential is to be obtained within 30 days of hire.

* Additional license requirements as determined by the hiring department.

Preferred Qualifications (Preferred)

• Current licensure to practice in a clinical field may be preferred.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Carrying, Listening, Manual Dexterity, Near Vision, Sitting, Speaking, Standing, Walking