Care Management Specialist - Galv. Campus Social Work M- F 8a- 5p

Care Management Specialist - Galv. Campus Social Work M- F 8a- 5p

Galveston, Texas, United States

Medical Administrative

UTMB Health

Requisition # 2403343

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 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 (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.

Compensation