How You’ll Help Transform Healthcare:
Provides direct support to the Social Work and Case Manager roles within Care Management to assure efficient, quality and cost effective services.
• Serves as a support resource at the direction of Social Work and Nurse Case Manager staff on the medical units and facilities.
• Resolves concerns including research and resolution of issues and requests ensuring a timely turnaround to facilitate throughput.
• Prioritizes and performs clerical duties to maintain workflow functions as primary responsibility or back up and as applicable to the department.
• Regulatory tasks that are federally mandated such as the Medicare Important Message letter delivery and the UAI long term care Medicaid approval process. Delivery of in person letters to patients (Medicare Important Rights, observation to IP and Code 44 ect).
• Process health plan specific referral requirements including prior authorizations, and assisting with denial resoultions as well as peer to peer initiations related to post-acute and throughput needs. Will be a resource/liaison with regard to payers, billing, staff, patients and providers. Field phone calls re: pricing, benefits, coverage, information about programs and insurance questions.
• Faciliates timely collection of paperwork, signatures, and other corespondance from the Care team and external agencies required to facilitate a timely discharge.
• Ability to travel between units, care areas, and floors of a medical facility to facilitate throughput needs
What We Require:
Education: Associate degree or equivalent combination of education or equivalent 4 years of experience preferred.
Experience: Two years experience in data collection and analysis and/or advanced secretarial support required. Experience in emergency services or physician practice setting preferred.
Licensure, certification, and/or registration:
Virginia MLTSS (UAI) Certification required to complete orientation and must be maintained throughout employment.
Other Minimum Qualifications: Advanced computer skills with knowledge of a variety of software programs, including Microsoft word, Excel, Access, word processing, spreadsheets and presentation or database software. Excellent communications and organizational skills required.
About Carilion
This is Carilion Clinic ...
An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.
Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.
Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.
Requisition Number: 138695
Employment Status: Full time
Location: CRMH - Carilion Roanoke Memorial Hospital
Shift: Day
Shift Details: Full time, Monday-Friday, 8 hour shift
Recruiter: DANA E JOHNSON
Recruiter Email: dejohnson@carilionclinic.org
For more information, contact the HR Service Center at 1-800-599-2537.
Equal Opportunity Employer
Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
Carilion Clinic is a drug-free workplace.