Case Management Specialist at Inova Health System

Fairfax, Virginia, United States -

Full Time

Start Date

Immediate

Expiry Date

22 Jun, 26

Salary

0.0

Posted On

24 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Case Management Coordination, Administrative Activities Support, Budget Processes, Arranging Services, Clinical Documentation, Financial Documentation, Regulatory Forms Delivery, Benefit Documentation, Issue Resolution, Payor Communication, Billing, Authorization, Utilization Review, State and Federal Forms Completion, Accounts Receivable/Payable Management, Vendor Contract Monitoring

Industry

Hospitals and Health Care

Description

Inova Fair Oaks Hospital is looking for a dedicated Case Management Specialist to join the team. This role will be Full-Time, Day Shift, Monday – Friday, 10-hour shift (8:00 a.m.- 6:30 p.m or 8-hour shift (8:00 a.m. - 4:30 p.m.), some weekends and holidays rotation required. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: * Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. * Retirement: Inova matches the first 5% of eligible contributions – starting on your first day. * Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans. * Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. * Work/Life Balance: offering paid time off, paid parental leave Case Management Specialist Job Responsibilities: The Case Management Specialist coordinates and performs administrative activities to support the Case Management department. Participates in the annual and ongoing budget processes, arranges services for assigned patient populations including Home Health, Durable Medical Equipment, Ambulance, Housing, Skilled Nursing Facility and others in order to ensure that appropriate continuing care services are in place for patient transitions. Communicates and documents accurate clinical/financial information in both verbal and written forms in order to assist Case Managers and/or Social Workers in appropriate assessments, implementations and evaluations of patients' continuing care needs. Delivers and documents delivery of regulatory forms such as the mandated Observation letter, and the Medicare IMM notifications. Receives and documents benefit and contract level requirements in order to ensure the appropriate utilization of benefits and services. * Conducts timely arrangements of services to meet customer requirements. * Addresses and solves provider and payor issues quickly with support from Case Management staff and performs other duties as assigned. * Distributes and documents delivery of mandated Observation and Medicare IMM/HINN letters as directed. * Communicates financial and clinical information to clinicians, patients, families, care team members and external customers. * Documents clinical and financial patient information in order to assist with discharge, planning and access to continuing care services. * Communicates with payor and documents detailed instructions on billing, authorization and utilization of services. * Completes state and federal forms related to patient level of care, according to regulatory standards, in order to assist with patient transition. * Manages and maintains state required UAI filings as well as all accounts receivable/payable functions for the department to ensure timely payments. * Maintains and monitors the system Case Management program including reimbursement of all negotiated vendor contracts. * Provides support to the strategic planning and business development initiatives of the department. Reviews and approves time/attendance for department staff on a biweekly basis. Performs periodic reviews to track employee time and attendance for department leadership. Submits any identified time/pay adjustments to Payroll in a timely manner. * Maintains records of all system Case Management files and acts as liaison to Foundation, auxiliary and external vendors. * Assists in monitoring the operational budget, in collaboration with department Director, related to funds disbursement and reconciliation. * Tracks and monitors accounting for budgets, capital requests, travel funds and business expenses. * Performs additional duties as assigned. Minimum Qualifications: * Education: High School or GED * Experience: 2 years of relevant experience Preferred Qualification: * Administrative/clerical experience in healthcare We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better — to shape a more compassionate future for healthcare. Inova Health System is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.

Responsibilities

The Case Management Specialist coordinates administrative activities to support the department, including arranging necessary continuing care services like Home Health and Durable Medical Equipment for patient transitions. This role involves communicating and documenting accurate clinical and financial information to aid Case Managers and Social Workers in patient assessments and evaluations.