Case Management Assistant, TCS (ECM)- Fresno 1.1

Paylocity; Fresno (CA); On-site; USD 29,000 - 37,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Paid Time Off (PTO)

Floating Holiday

Simple IRA Plan with a 3% Employer Con

Employer Paid Life Insurance

Employee Assistance Program

Job summary

Universal Healthcare MSO in Fresno is hiring a Case Management Assistant for the Transitional Care Services program. The role supports nurses and social services in coordinating transitions from hospital to home or other settings, within the Enhanced Care Management program.

You will assist with referrals, scheduling, and data collection, while maintaining strong communication with members and the interdisciplinary team to meet complex medical and social needs.

Qualifications

• Strong interpersonal and organizational skills are required.
• Experience coordinating care transitions and referrals is preferred.
• Familiarity with case management workflows and data entry in CM systems is expected.

Responsibilities

• Assist Case Managers in coordinating post-discharge services.
• Gather clinical information and schedule provider appointments.
• Ensure post-discharge referrals are received and follow-care needs are communicated.
• Coordinate transportation and services for transitions of care.
• Facilitate transfer of orders via phone, fax, and e-prescribing.
• Document care management activities in the CM system and monitor patient status.

Skills

Interpersonal skills

Organizational skills

Care coordination

Documentation in CM System

Tools

CM System

Job description

Description

Location: Fresno, CA. (Onsite)

Classification: Full-Time

This position is non-exempt and will be paid on an hourly basis.

Schedule

Monday- Universal Healthcare MSO's standard operating hours are Monday through Friday, from 8:00 a.m. to 5:00 p.m. Pacific Time. Unless otherwise specified, all employees are expected to work their assigned schedules and remain available during these operational hours.

Benefits

• Medical
• Dental
• Vision
• Paid Time Off (PTO)
• Floating Holiday
• Simple IRA Plan with a 3% Employer Contribution
• Employer Paid Life Insurance
• Employee Assistance Program

Compensation

The initial pay range for this position upon commencement of employment is projected to fall between $21.31 and $26.63. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

Position Summary

The Case Management Assistant- Transitional Care Services (TCS) provides support for the Case Management Department, including the Nurse Case Managers and Social Services team specifically through the coordination of services within the Enhanced Care Management (ECM) Program specific to transitional care services. The Case Management Assistant will provide support by assisting in managing members who are undergoing transitions from various care settings, including ER visits, acute care admissions, post-acute care admissions, incarcerations, and other ECM-recognized transitional care settings. The Case Management Assistant TCS will assist in enhanced care coordination activities, monitor members, report findings, and gather clinical information from outside sources. The ECM Program addresses the clinical and non clinical needs of members with the most complex medical and social needs through systematic coordination of services and comprehensive care management. ECM is intended to service those with chronic health conditions, are homeless or at-risk, with high hospital admissions, substance abuse, and/or behavioral health needs. This position requires strong interpersonal and organizational skills to build rapport with members, coordinate referrals, and care amongst various healthcare providers and community services. The Case Management Assistant TCS also collaborates with the member’s inter-disciplinary team (ICT) supporting the member, while engaging the member and their support systems to define priorities that are central to the member’s desired needs and goals.

Job Duties and Responsibilities

• Works collaboratively and assists the Clinical or Social Services Case Manager to manage members in need of Transitional Care Services.
• Gather clinical information and assists with coordinating post-discharge services, including scheduling provider appointments, ensuring post-discharge referrals are
• received by the member, transportation to appointments is arranged, and members are aware of follow-care needs.
• Proactively initiates care transition coordination with referral sources and internal partners to ensure seamless patient transitions to home or ATS. Participates with any data collection required for therapy start and patient tracking process. This may include
• facilitating the transfer of orders via phone, fax, and e-prescribing.
• Effectively manage low acuity member cases within the ECM Program.
• Contacts members at regular intervals per their acuity level and care plan needs.
• Completes member questionnaires or assessments, and consistently document care management activities and encounters in the CM System, per program protocol.
• Works collaboratively and assists clinical and social services Case Managers with care coordination, member follow-up, communication with appropriate agencies and preparation and distribution of documents and/or reports.
• Reports variances and issues to nursing or social services staff assigned to the member.
• Assists members with appointment scheduling, transportation, referral coordination, and other enhanced care coordination services.
• Gathers clinical information from outside sources such as PCPs, specialists and other providers, electronic health records, and other partnering entities.
• Verifies member eligibility, demographic information, and benefits.
• Verifies member's Primary Care Physician and the Physician Specialist to ensure that authorization is requested and issued to appropriate network provider.
• Assists in maintaining the integrity of the data systems by entering information into department’s data systems.
• Provides general Office administration duties including answering phones. Provides general customer service to all potential and exiting ECM members and partnering agencies.
• Gathers relevant information for the identified member population during assessment, care planning, interdisciplinary care team meetings, and transitions of care.
• Outreaches to members to verify that needs are being met and services are being delivered.
• Intervenes at the member level to coordinate the delivery of direct services to the member and their families.
• Serves as an associate and resource to members, providers, staff, and external customers regarding policies, benefits, and care coordination.
• Assists with system letters, requests for information and data entry.