Case Management Coordinator at Astiva Health

Orange, California, United States -

Full Time

Start Date

Immediate

Expiry Date

07 Oct, 26

Salary

0.0

Posted On

09 Jul, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Case Management, Care Coordination, Data Entry, Patient Assessment, Medical Terminology, Prior Authorization, Interpersonal Communication, Problem Solving, Resource Coordination, Patient Outreach

Industry

Hospitals and Health Care

Description

Description Accurately enter confidential data into the case management system to ensure timely care coordination and outreach. Verify member benefits and eligibility upon receipt of care coordination or case management. Utilize DOFR or delegation agreements to drive decision making. Coordinate and assist with patient appointments, transportation or utilize community resources. Gather relevant information for the identified member population during assessment, care planning, interdisciplinary care team meetings, and transition of care. Complete applicable patient assessments in a timely manner. Coordinate with case manager to actively problem solve for patients. Proactively outreach to patients to verify that needs are being met and services are being satisfactorily delivered. Intervene at the client level to coordinate the delivery of direct services to clients and their families. Coordinate with primary can specialty providers to provide care to patients. Ensure all documentation and communication is complete and updated to partners at the IPA or MSO level and all clinical teams are updated to authorize patient services. Review all available community resources prior to requesting patient services for use and authorization. Serve as a resource for patients, providers, internal teams and external customers regarding plan policies, benefits, and care coordination. Support the Utilization Management department by uploading member admission, home health and skilled nursing facility admissions. Collaborate with department leadership to coordinate calendars for meetings and coordinate interdisciplinary team communications. Serve as the Outreach Liaison between the IPA/MSO’s for all delegation reports and communications. Regular and consistent attendance Other duties as assigned Requirements High School diploma or GED required. Minimum of 2 years of experience working in the healthcare industry. Minimum of 1 year of prior experience working, training, or education within a healthcare environment. Strong working knowledge of prior authorization, case management principals, and regulations governing Medi-Cal, Medicare, and other government and commercial healthcare programs. Working knowledge or medical terminology. Excellent written and verbal communication skills with the ability to build and foster strong interpersonal relationships. Bilingual in a second language preferred.

Responsibilities

The coordinator is responsible for entering confidential data into case management systems and coordinating patient care, appointments, and community resources. They serve as a liaison between patients, providers, and internal teams to ensure timely service delivery and authorization.