Care Management Associate - Case Management - FT - Days - Irvine

University of California, Irvine•Orange, CA

About The Position

Position Summary: In collaboration with the case manager, patient/family, healthcare team and payors, incumbent coordinates the care services for assigned patients for an episode of illness or treatment as defined by the case manager. Promotes the effective utilization of resources using current knowledge and awareness of community resources to achieve optimal care. This includes assisting with discharge planning, insurance verification & authorization, obtaining necessary resources, sending referrals, making follow up medical appointments, and appropriate documentation of activities in all required computer systems.

Requirements

Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties
Must demonstrate general understanding of medical terminology
Must demonstrate customer service skills appropriate to the job
Minimum of 2 years experience in a hospital or medical office setting
Extensive and demonstrated knowledge of Government and Commercial Insurance Plans
Experience with registration and/or billings computer software programs
Excellent written and verbal communication skills in English
Demonstrated knowledge and understanding of Managed Care plans
Demonstrated experience with referral authorization process
Demonstrated experience with MS Office (Word, Excel, Outlook)
Demonstrated ability to utilize payer and government websites to access and interpret health plan benefit packages and make determinations
Ability to work weekends, holidays, and evenings
Ability to maintain a work pace appropriate to the workload
Ability to interpret and understand various medical insurance plans and make accurate determinations regarding coverage
Ability to establish and maintain effective working relationships across the Health System
Must be able to provide proof of work authorization