Case Management Navigator

Job Requisition: REQ3118

Employment Type: Full-Time

Shift: Days

Hours Per Week: 40 hours

Hiring Range :  $18.35-$24.55

The actual compensation for this position will be determined based on experience and other factors permitted by law.

Responsibilities:

 Assist Care Managers/discharge planners with post discharge follow up appointments and transportation.

 Provide administrative support such as data entry, filing, and document preparation, uploading data to websites.

 Ensure adherence to confidentiality and privacy policies.

 Facilitate follow ups and check ins with patients to ensure service satisfaction.

 Prepare reports and documentation for case reviews and audits.

 Assist the Utilization Management team with transmitting clinical to insurance companies and document approvals.

 Assist Utilization Management team with tracking denials/appeals via spreadsheet.

 Issues CMS notices to patients/families and documents in the medical record.

 Performs internal audits of quality measures for the department.

 Assures timely transmission of discharge summaries and other pertinent information to the community based agencies providing care to the patient, or to the facility that is providing care to the patient following discharge.

 Prepares agendas for department meetings, documents meeting minutes, and secures required materials appropriate for the meeting.

 Collaborates with multi-disciplinary team, including clinical and non-clinical, working to provide assurance that medications are obtainable and obtains prior auth as needed to ensure coverage.

 Exhibits knowledge and skill in all functions of the electronic medical record pertinent to successful job performance.

 Compiles data and statistics as directed to illustrate referral activities and referral elements required.

 Compiles data and statistics for monthly, quarterly, and annual requirements.

 Prepares data for UM Committee meetings/presentation.

Education, Training & Experience High school diploma/GED required.

Bachelor's degree in social work, or related field or LPN preferred. Preferred Qualifications:  Familiarity with healthcare and social service systems  Proficiency in using Case management software  Experience with social services systems

Must be able to speak, read, write and follow instructions in English.