CASE MANAGEMENT ASSISTANT -

UNM Hospital; Albuquerque (NM); On-site; USD 25,000 - 39,000; Part time

Job summary

UNM Hospital in Albuquerque, NM seeks a part-time Utilization Management support specialist to assist in case management and admissions/discharge processes across age groups. Under supervision, you will coordinate referrals, arrange resources, and ensure adherence to policies and patient safety guidelines.

The role emphasizes communication with the treatment team, families, and outside agencies, with tasks including data collection, documentation, and coordination of home health services as

Qualifications

• High School or GED equivalent is required.
• Associate or Bachelor's degree is preferred but not required.
• Bilingual abilities in English and another language are valued.

Responsibilities

• ARRANGEMENTS - Arrange meals, lodging and transportation for families as requested
• COORDINATION - Assist in coordinating medical equipment and supplies for home use, communicating with appropriate members of treatment team, family and patient as directed
• COORDINATION - Assist in making arrangements for home health services as directed
• COMMUNICATION - Communicate plans for equipment, transportation, referrals, etc., as appropriate, to members of the treatment team; perform follow-up communication with patients or appropriate designee as needed
• COMMUNICATION - Communicate with appropriate staff, patients or designees and outside agencies regarding any necessary financial information, as directed
• TRANSFER - Assist with coordinating transfer of patients to appropriate settings, i.e., acute care, psychiatric inpatient, skilled nursing facility, or other destinations
• CONFERENCES - Coordinate patient care conferences, as requested
• COMMUNICATION - Participate in patient care team meetings to review follow-up actions and patient discharge planning
• CORRESPONDENCE - Formulate, copy, fax and distribute correspondence and medical records, as directed
• DATA - Collect and enter required data; prepare reports as directed
• INQUIRIES - Answer phones, obtain appropriate information, respond to requests and transfer calls; retrieve messages and route, as appropriate
• PATIENT ASSISTANCE - Assist patient or designee in completing patient assistance forms/documentation, and maintain records
• PRIOR AUTHORIZATION - Verify coverage eligibility on patients for outside services as needed
• FINANCIAL ASSISTANCE - Coordinate and obtain missing information related to denials due to the lack of notification authorization
• RECORDS - Establish, maintain, process, and update files, records, and/or other documents
• REFERRALS - Maintain resources and reference materials; direct referrals to community agencies, as needed
• DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
• PATIENT SAFETY 1 - Follow patient safety-related policies, procedures and protocols
• PATIENT SAFETY 2 - Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes
• PATIENT SAFETY 3 - Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk
• PATIENT SAFETY 4 - Report potential or actual patient safety concerns, medical errors and/or near misses in a timely manner
• PATIENT SAFETY 5 - Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right"

Skills

Medical terminology

Case management

Utilization management

Bilingual English/Spanish

Bilingual English/Vietnamese

Education

High School or GED Equivalent

Associate Degree

Bachelor's Degree

Job description

Receive 17% Weekday Nights, 26% Weekend Nights and 15% Weekend Day shift differentials

Compensation Disclaimer

Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.

Department: Utilization Management - UH

FTE: 0.50

Part Time

Shift: Weekend Days

Position Summary:

Under the supervision of department Director or designee, assist in providing case management services; assist in some aspects of the admissions and discharge process to facilitate smooth and timely admission and discharge and appropriate referral to available resources. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups.

Detailed Responsibilities:

• ARRANGEMENTS - Arrange meals, lodging and transportation for families as requested
• COORDINATION - Assist in coordinating medical equipment and supplies for home use, communicating with appropriate members of treatment team, family and patient as directed
• COORDINATION - Assist in making arrangements for home health services as directed
• COMMUNICATION - Communicate plans for equipment, transportation, referrals, etc., as appropriate, to members of the treatment team; perform follow-up communication with patients or appropriate designee as needed
• COMMUNICATION - Communicate with appropriate staff, patients or designees and outside agencies regarding any necessary financial information, as directed
• TRANSFER - Assist with coordinating transfer of patients to appropriate settings, i.e., acute care, psychiatric inpatient, skilled nursing facility, or other destinations
• CONFERENCES - Coordinate patient care conferences, as requested
• COMMUNICATION - Participate in patient care team meetings to review follow-up actions and patient discharge planning
• CORRESPONDENCE - Formulate, copy, fax and distribute correspondence and medical records, as directed
• DATA - Collect and enter required data; prepare reports as directed
• INQUIRIES - Answer phones, obtain appropriate information, respond to requests and transfer calls; retrieve messages and route, as appropriate
• PATIENT ASSISTANCE - Assist patient or designee in completing patient assistance forms/documentation, and maintain records
• PRIOR AUTHORIZATION - Verify coverage eligibility on patients for outside services as needed
• FINANCIAL ASSISTANCE - Coordinate and obtain missing information related to denials due to the lack of notification authorization
• RECORDS - Establish, maintain, process, and update files, records, and/or other documents
• REFERRALS - Maintain resources and reference materials; direct referrals to community agencies, as needed
• DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
• PATIENT SAFETY 1 - Follow patient safety-related policies, procedures and protocols
• PATIENT SAFETY 2 - Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes
• PATIENT SAFETY 3 - Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk
• PATIENT SAFETY 4 - Report potential or actual patient safety concerns, medical errors and/or near misses in a timely manner
• PATIENT SAFETY 5 - Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right"

Qualifications

Education:

Essential:

• High School or GED Equivalent

Nonessential:

• Associate Degree
• Bachelor's Degree

Nonessential:

• Related Discipline
• Related Discipline

Experience:

Nonessential:

No minimum experience required

Medical terminology knowledge Bilingual English, Spanish, Keres, Tewa, Tiwa, Towa, Zuni, or Navajo Bilingual English/Vietnamese Case management experience Utilization management experience 2 years directly related experience

Credentials:

Essential:

• Not Applicable/Not Required

Physical Conditions:

Light Work: Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. May require walking or standing to a significant degree or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or may require working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of materials is negligible.

Essential:

Working conditions:

• Minor Hazard - physical risks, dirt, dust, fumes, noise
• Tuberculosis testing is completed upon hire and additionally as required