Case Management Assistant

POSITION SUMMARY: Perform the duties required to act as a liaison between medical providers, social service agencies and community health department to assure the requested case management services are provided.

POSITION QUALIFICATION REQUIREMENTS:

Education: Requires high school graduate or equivalent. Associates Degree preferred.

Experience: Requires three (3) years of experience in health care, social services, or related field.

Skills and Abilities (which may be representative but not inclusive of those commonly associated with this position).

1. Knowledge of Medicaid and MC+ programs.
2. Highly proficient computer skills with Outlook, Word, Excel, and experience with an EMR.
3. Demonstrates initiative, flexibility, and excellent organizational skills.
4. Strong oral and written communication skills which demonstrate excellent customer service and teamwork .
5. Ability to maintain a professional attitude and demeanor at all times.
6. Ability to keep information confidential.

Transportation Requirement: Must possess a valid driver's license and automobile with insurance coverage as required by the State of Missouri.

License(s)/Certification(s) Required: CPR Certification

FUNCTIONS OF THE JOB

Essential Functions:

1. Acts as liaison between medical providers, insurance companies, various agencies, and community health nurses.
2. Requests authorization from HMO's for specialty services (i.e. OB Care and Case Management services. Follows up with HM.O's on prior authorizations requests and insurance company notifications
3. as well as tracks the HMO's requests for the organization. Reviews and rectifies missing Global notifications.
4. Work with organization billing department to track authorization from HMO's when billings are denied.
5. Provides the Managed Care Plans with timely documentation to include but not limited to risk factors, request for global authorizations, and reports pertaining to open and closed cases to ensure insurance coverage for prenatal patients.
6. Maintains and updates insurance information on Case Management spreadsheets.
7. Participates in Prenatal Intake at the various Health Centers by coordinating the care for patients to ensuring they receive services from Outreach, WIC, Maternal Child Nursing, Centering, Dental, and Radiology.
8. Assists with the scheduling of specific patient appointments, makes reminder appointment calls, and contacts patients who have missed scheduled appointments when necessary.
9. Visit postpartum patients at the hospital to obtain necessary postpartum, delivery, and newborn information.
10. Effectively works with other health care team members to ensure coordination of care.
11. Performs other duties as assigned

Marginal Functions

1. Attend and actively participate at required meetings.
2. Assists in preparation of monthly reports regarding case management activities

Supervises: None

NOTE: Affinia Healthcare is a Covid-19 Vaccine Mandated Employer. All employees of Affinia Healthcare are required to be vaccinated for Covid-19, unless an approved exemption for a qualified medical or religious reason.

NOTE: SMOKING IS PROHIBITED IN THE WORK ENVIRONMENT

NOTE: ALL APPLICANTS MUST PROVIDE CONTACT INFORMATION FOR THREE REFERENCES

AN EQUAL OPPORTUNITY SERVICES PROVIDED ON A NON-DISCRIMINATORY BASIS

Current Openings for Case Management Assistant Jobs at Affinia Healthcare