Position Description

Case Management Specialist, Care Coordination, Full-Time, Days
Location City Greenbrae, CA 
Bargaining Unit
Compensation $28.81 - $43.21/hr.
Apply Now

Case Management Specialist, Care Coordination, Full-Time, Days

Greenbrae, CA

ABOUT MARINHEALTH
Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team, an affiliation with UCSF Health, an ever-expanding network of clinics, and a new state-of-the-art hospital, MarinHealth is growing quickly. MarinHealth comprises MarinHealth Medical Center, a 327-bed hospital in Greenbrae, and 55 primary care and specialty clinics in Marin, Sonoma, and Napa Counties. We attract healthcare’s most talented trailblazers who appreciate having the best of both worlds: the pioneering medicine of an academic medical center combined with an independent hospital's personalized, caring touch.

MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others.

What We Offer
MarinHealth offers a comprehensive suite of employee benefits that support your health, wellness, and financial security. Our robust Wellness@Work program includes onsite health & fitness classes, discounts, and promotes a healthier lifestyle for employees. We also provide a 403(b) contribution plan and company-funded retirement plan, life insurance, vacation, holiday, and sick leave. These benefits, along with our highly competitive compensation package, make MarinHealth one of the best places to work in the Bay Area. Join us and find your next career at MarinHealth.

External hires are subject to a background check and pre-employment medical screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal, state, and local laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sexual orientation, gender identity, protected veteran status or disability status, and any other classifications protected by federal, state, and local laws.

 

JOB SUMMARY:

 The Case Management Specialist (CM-S) is responsible for providing technical, administrative and clerical support to the case management department. The CM specialist acts independently with oversight of the case manager to maintain regulatory compliance, facilitate appropriate patient placement, and to implement the discharge plan developed by the case manager.  

JOB SPECIFICATIONS:

 EDUCATION

 A.A degree in Business /Health Related field or equivalent experience in a health care setting required  

EXPERIENCE

  •  Proficiency in medical terminology,
  • Experience in utilization review or discharge planning, financial counseling or registration
  • Minimum of 2 years of job related experience in a health care setting
  • Proficiency with electronic health record (EHR) and other case management applications i.e. MIDAS 

PREREQUISITE SKILLS

  • Knowledge of available health care and community resources appropriate to the population served
  • Knowledge of alternative levels of care including criteria required for payment and application processes
  • Knowledge of transportation criteria
  • Ability to carry out instruction provided in written or oral
  • Ability to manage , set priorities and operate with minimal direct supervision and can work effectively under pressure 

LICENSE/REGISTRATION/CERTIFICATION:

None  

DUTIES AND RESPONSIBILITIES:

 ESSENTIAL (not modifiable)

  •  Supports the utilization management process by entering requests for utilization review, authorization of stay for concurrent and post billing denials to support case management workflow.
  • Collaborates with RN and Social Work case managers as requested to provide post-acute referrals for discharge planning needs.
  • Executes the discharge plan developed by the care coordination team by initiating timely referrals to other services and facilities as necessary under the supervision of the RN and SW case manager.
  • Verifies benefits and prior authorization requirements from insurers and documents findings in the electronic medical record.
  • Presents community resource lists and post acute care vendor lists as directed by the case manager.
  • Independently and proactively initiates follow-up with post acute referral setting to ensure services are confirmed to facilitate timely discharge.
  • Provides the Second IM letter to Medicare patients prior to discharge per regulatory guidelines and documents in the medical record.
  • Provides Observation Notification letters to patients as directed by the RN or SW case manager with explanation of observation status, obtains patient signature and ensure Observation Notification is scanned into patient’s EHR.
  • Documents accurately, thoroughly, and legibly in the medical record.
  • Demonstrates proficiency in use and application of all electronic applications.
  • Makes patient transportation arrangement as necessary insuring proper authorization from insurance source.
  • Answers multiple and /or designated telephone lines, able to prioritize and route calls. Documents telephone calls to the department in Call Log book.
  • Prepares denial letters as indicated per department policy and regulatory guidelines under the supervision of the RN or SW Case Manager.
  • Provides clerical support as needed including copying, faxing and data entry.
  • Collaborates with team members on interdependent tasks. Demonstrates both initiative and flexibility working with Physicians, Case Managers and other staff.
  • Ensures that routine and priority tasks are completed within established departmental time frames.
  • Positively contributes to team decision making process in planning daily priorities, resolving barriers to discharge plans seeking creative solutions.

At MarinHealth, our top priority is the well-being of our employees, patients, and community. As such, we require all employees to receive necessary immunizations, including the measles, mumps, varicella, and seasonal flu vaccinations as a condition of employment and annually thereafter. Additionally, the continued recommendation to obtain a COVID + booster vaccination status. We understand that some individuals may require medical or religious exemptions from these requirements, but we remain committed to prioritizing the health and safety of all. Thank you for helping us in our efforts to maintain a healthy and safe environment for all.

 

The compensation for this role listed on this posting is in compliance with applicable law.  The selected candidate’s compensation will be determined based on the individual’s skills, experience, internal/market equity factors, and qualifications.  This posted minimum and maximum range represents the minimum and maximum of what we reasonably expect to compensate for the position.  Furthermore, all compensation decisions are ultimately determined in accordance with our compensation philosophy.  Compensation for positions covered by collective bargaining agreements are governed by the agreements in the aforementioned document.

Additional Information

  • Department: 8751 - Care Coordination
  • Job Schedule: Full Time - 40 hours/week
  • Job Shift: Day
  • Hours per Two-Week Period: 80
  • Shift Hours: 8 Hour Shift
  • Job Number: 13720 - AUTBD
Back Apply Now