Case Management Assistant

San Gorgonio Memorial Hospital; Banning (CA); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical insurance

Flexible spending accounts

Paid time off

Job summary

San Gorgonio Memorial Hospital is seeking a Case Management Assistant to support RN Case Managers and Social Workers in coordinating post-acute care for hospitalized and ED patients, following department policies.

The role includes preparing referral packets, arranging transportation, obtaining authorizations, documenting actions, and maintaining records while communicating with patients, families, and providers.

Qualifications

• High School education or equivalent GED preferred.
• Medical terminology preferred.
• Some College Preferred.

Responsibilities

• Support RN Case Managers and Social Workers with post-acute care arrangements.
• Prepare and fax referral packets for transfers to Skilled Nursing Facility, Home Health Care agencies, Hospices, Durable Medical Equipment companies and transfers to higher levels of care.
• Arrange medical transportation where required, including receiving insurance or medical group authorization.
• Prepare and fax necessary documentation to facilitate prior authorization of off‑formulary drugs for home use.
• Follow up on referrals by phone to ensure receipt and documentation.

Skills

Clerical skills

Communication skills

Medical terminology

Computer skills

Education

High School diploma or GED

Some College Preferred

Medical terminology preferred

Job description

POSITION SUMMARY:

The Case Management Assistant provides hands‑on post‑acute care planning services to our hospitalized and emergency department patients, as assigned by an RN Case Manager or Social Worker, in accordance with department policies and procedures. In incumbent will also support the RN Case Management staff in level of care screening according to department policy and procedures.

ESSENTIAL DUTIES (not all inclusive):

• As assigned, provide support to the RN Case Managers and Social Workers in completing routine post‑acute care arrangements. This includes setting up routine post‑acute services according to MD orders, keeping the case manager or social worker informed sufficiently for them to document final disposition, and other activities according to department policies and procedures.
• Document actions according to hospital and department standards
• Prepare and fax referral packets for transfers to Skilled Nursing Facility, Home Health Care agencies, Hospices, Durable Medical Equipment companies and transfers to higher levels of care.
• Prepare and fax referral packets for transfers to Skilled Nursing Facility, Home Health Care agencies, Hospices, Durable Medical Equipment companies and transfers to higher levels of care.
• Arrange medical transportation were required, including receiving insurance or medical group authorization.
• Prepare and fax necessary documentation/information to facilitate prior authorization of off‑formulary drugs for home use.
• Follow up on the above referrals by phone to ensure receipt of referral to intended company/facility and ensure all necessary information/documentation was provided. Receive and document authorizations requested.
• Receive and respond to all fax/phone requests from facilities/companies and provide pertinent information to acquire approval/placement for patients needs on behalf of Case Managers and Social Workers.
• Notify Case Manager or Social Worker assigned to patient upon receipt of new orders for consultations, notify of any new discharge/placement orders received, and notify social worker of any social service consults received.
• Contact insurance companies/medical groups to acquire authorization for post‑acute provider services.
• Verify patient personal information and service address for Home Care post‑acute providers.
• Receive authorizations/reference codes from insurance companies via phone and fax, document and forward to the assigned registration staff.

REQUIREMENTS:

• Education:
  • High School education or equivalent GED preferred.
  • Medical terminology preferred.
  • Some College Preferred
• Licensure: N/A

Other Skills:

• Must have excellent clerical and organizational skills.
• Must have excellent communication/people skills in person and on the phone.
• Must be familiar and comfortable with medical terminology.
• Above average Computer Skills.
• Attends annual updates or education days or in‑service.
• Annual departmental competencies.

PAY / BENEFITS

• Estimated pay based on qualifications (including but not limited to experience, education, certifications, and licensure where applicable).
• Benefits may include medical, dental, vision, basic life and AD&D, optional supplemental life (employee, spouse, and/or child coverage), flexible spending accounts (medical and dependent care), 403b retirement with dollar for dollar match up to 5%, paid time off, and more available depending on employment status.

M/F/D/V/SO

EOE