Job Description

Under limited supervision, assists Care Management team with a variety of administrative functions. Coordinates within the CM team as well as with other disciplines throughout the hospital to ensure smooth care transitions. Responsible for maintaining hospital compliance with a variety of documentation, including but not limited to, IMM, MOON, and OBS letters. Also responsible for obtaining prescription authorizations, Skilled Nursing authorizations, making PCP appointments for patients as well as conducting follow up discharge calls to patients who have been recently discharged.

Education:

Bachelor’s degree or equivalent experience preferred

Experience:

Three years’ experience in a health care setting preferred

Three years’ customer service experience preferred

Skills:

• Knowledgeable of available community resources
• Advanced skills in oral and written communication
• Skill in organizing workload and balancing many tasks
• Skills in time management
• Skills in data and statistical analysis
• Ability to evaluate data gathered for medical plan of treatment

Physical Requirements

• Ability to concentrate and pay close attention to detail, walk around the hospital from patient room to patient room as well as travel to other units around the organization.
• Ability to work off of work queues
• Speak with patients and families to deliver letters, answer questions etc.
• Call pharmacies as well as insurance companies to obtain authorizations

Working Conditions

• Work is performed inside the organization’s offices, patient care units, or in patient rooms. Job attendance is required during all types of weather conditions.

Patient & Workplace Safety:

• Employee has knowledge and understanding of patient and workforce safety as it relates to job duties.

Patient Population:

• Demonstrates competency in the delivery of care and applies the knowledge to meet age-specific needs if applicable.

Principal Duties and Responsibilities

• Ensures that IMM, OBS, MOON letters are given to patient in a timely manner to meet all regulations.
• Ensures delivery of the Secondary IMM letter
• Responsible for delivery of Medicare Important Message (IMM) letter, Acknowledgement of Outpatient Services letter, and MOON letter, distribution and discussions.
• Schedules appointments with primary care physicians (PCPs) for patients at high risk for re-admissions.
• Assists Care Management team with a variety of administrative tasks including, but not limited to: Discharge paperwork, Faxing, Referrals, Follow-up phone calls, PCP appointments, Authorizations
• Documentation in EPIC of work completed in notes, work queues, Media section for forms as well as PCP appointments, AVS and discharge summary

GBMC Values

Value Description

Respect

• Treats others with fairness, kindness, and respect for personal dignity and privacy
• Listens and responds appropriately to others’ needs, feelings, and capabilities

Excellence

• Meets and/or exceeds customer expectations
• Actively pursues learning and self development
• Pays attention to detail; follows through

Accountability

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

Teamwork

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

Ethical Behavior

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently

Pay Range

$19.92 - $29.87

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

Equal Employment Opportunity

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.