The Care Management Specialist oversees and coordinates the patient's post-discharge experience. They are skilled in providing excellent customer service and consulting with patients by coordinating patient services and other medical-related services offered by a healthcare team. Obtains authorizations for inpatient services; performs telephone triage and referral. Facilitate the approvals for UTMB inpatient services. EDUCATION & EXPERIENCE Minimum Qualifications: High School or equivalent Three... more details
JOB DESCRIPTION
The Care Management Specialist oversees and coordinates the patient's post-discharge experience. They are skilled in providing excellent customer service and consulting with patients by coordinating patientservices and other medical-related services offered by a healthcare team. Obtains authorizations for inpatient services; performs telephone triage and referral. Facilitate the approvals for UTMB inpatient services.
EDUCATION & EXPERIENCE
Minimum Qualifications:
High School or equivalent
Three (3) years of customer service or related experience in a healthcare or clinical setting
Preferred Qualifications:
Associate Degree or equivalent combination of education and training/experience
ESSENTIAL JOB FUNCTIONS
Collaborate with the Care Coordinator and Social Worker to facilitate discharges, prioritizes daily tasks, and round on units several times a day to identify discharge barriers.
Manage patient's discharge readiness and final discharge plans; provides resources to patients and families as needed. Tracks discharge barriers appropriately.
Verifies referral received to make post-discharge arrangements for patients.
Coordinate on behalf of the Care Manager or Social Worker to offer the patient's choice of post-acute preferred providers.
Notifies designated referral place of the need for admission and verifies bed availability.
Prints/copies sections of the chart to fax or send to accepting agencies/facilities to ensure the patient's treatment plan continues.
Arranges transportation as directed by the Care Coordinator or Social Worker; ensure compliance with Medicare and third-party coverage. Communicate with patient, referral source, UTMB physician, and clinical staff about access or authorization challenges.
Coordinates transportation by calling insurance companies to check on ambulance pre-authorization.
Obtains authorizations for DME, SNF, and home health.
Delivers Important Medicare and/or Medicare Outpatient Observation Noticeletters when directed by Care Coordinator or Social Worker.
Documents discharge referral/treatment plan in the chart.
Other duties as assigned
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
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