Position Highlights:

Key elements of the role of Case Management Assistant include: concurrent utilization review as assigned, management of retrospective reviews for Medical (eQHealth and the Billing Errors Worklist), covers for the Case Management MA when she is out. Provides Medicaid review orientation and training for new team members in any department that requires this support. This role also covers some support for the Case Management  Management Assistant role when the Management Assistant is not available. The Case Management Assistant provides direct discharge planning support to the Case Managers.

The Ideal Candidate

The ideal candidate will have the following qualifications:

• Two-year degree preferred with a focus on human anatomy and medical terminology
• Multiple systems computer experience preferred
• Minimum 2 years of experience in health care field
• Experience with InterQual Review criteria is need and experience with Milliman will be considered
• Acute care or insurance experience

Responsibilities:

• Screens incoming calls for Case Management Department and routes for appropriate action when Case Management MA is not available
• Perform independent concurrent stay utilization review for both commercial and governmental systems and is able to support external QIO review
• Able to cover the Case Management Management Assistant’s duties when needed
• Act as a trainer for the systems used within the department
• Support clerical tasks associated with discharge planning

Credentials and Qualifications:

• High School Diploma/GED
• Associates Degree Preferred
• Two years’ experience in health care field
• Experience with InterQual Review criteria and Milliman