Shire Jobs

Mobile Shire Logo

Job Information

Actalent Case Management Assistant in Jacksonville, Florida

Job Title: Case Management Assistant

Job Description

As a Case Management Assistant, you will play a crucial role in assisting with UR transmission and coordinating the transition of care (TOC) and discharge (DC) plans for ambulatory patients. You will prioritize and manage the care plan through critical thinking, teamwork, and communication between care providers, patients, families, and external vendors to ensure timely discharge.

Responsibilities

  • Collaborate with Case Managers and Social Workers to assess patients and identify post-hospital support and discharge needs.

  • Communicate and problem solve with Case Managers and Social Workers to develop the TOC plan, offering choices and preferences for post-acute providers and available resources.

  • Ensure patients and medical facilities receive information on benefit coverage and partner with payers when needed.

  • Monitor progress towards TOC goals and escalate any barriers to achieving recommended goals to Case Managers and Social Workers.

  • Keep patients and medical facilities informed of the progression of the TOC plan throughout the hospital stay.

  • Coordinate all necessary post-discharge referrals and authorizations in collaboration with the CC team.

  • Monitor and communicate the status of post-hospital provider referrals and progress in TOC goals to promote timely discharge.

  • Facilitate the transfer of patients to appropriate post-acute facilities, preparing documents, obtaining physician signatures, and assisting with transportation services.

  • Round with Case Managers and Social Workers on units to provide updates and receive direction on needed assistance.

  • Deliver the Medicare 'Important Message' and inform patients or medical facilities of their right to appeal their discharge.

  • Identify, communicate, and resolve barriers that impede a timely TOC plan, escalating unresolved barriers as needed.

  • Participate in daily team huddles and CC department meetings.

  • Contribute to team decision-making processes by planning daily priorities and resolving barriers.

  • Collaborate with team members on interdependent tasks and demonstrate initiative and flexibility.

  • Share knowledge and information with team members and build relationships that foster trust.

  • Maintain accurate, current, and legible documentation according to department standards.

  • Enter CC notes in the electronic medical record and capture key discussions and agreements.

  • Enter final post-discharge provider information and ensure closure of discharge cases in Allscripts.

  • Provide clerical support, including copying, faxing, scanning, and data entry.

  • Complete all forms required for department reporting.

Essential Skills

  • Data entry experience

  • Knowledge of payers

  • Auth/case management experience preferred

  • EPIC experience

  • Good communication skills

  • Teamwork skills

  • Conflict management/resolution

  • Adaptable to change

  • Ability to type 55 or more WPM

Additional Skills & Qualifications

  • 1-year recent relevant experience (Customer service/medical field/insurance/case management assistance/etc.)

  • High School Diploma (required)

  • Must live CST or EST

Work Environment

This is a 100% remote position. You must be open to rotating weekends. The shift is a day shift, 5x8-hour (07:00 - 17:00), though hours may vary.

Pay and Benefits

The pay range for this position is $17.00 - $17.00

• Medical, dental & vision• Critical Illness, Accident, and Hospital• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available• Life Insurance (Voluntary Life & AD&D for the employee and dependents)• Short and long-term disability• Health Spending Account (HSA)• Transportation benefits• Employee Assistance Program• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position will be accepting applications until Dec 22, 2024.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

  • Hiring diverse talent

  • Maintaining an inclusive environment through persistent self-reflection

  • Building a culture of care, engagement, and recognition with clear outcomes

  • Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.

DirectEmployers