Case Management Assistant
Company: UnitedHealth Group
Location: Logan
Posted on: March 15, 2020
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Job Description:
POSITION DESCRIPTION
APPLECARE MEDICAL MANAGEMENT GROUP was incorporated in 2003. Over
the last 17 years, the multispecialty medical group of independent
practices has expanded into new communities, contracted with more
hospitals and health plans, and added over 50 new doctors - but the
mission has remained the same. Today, APPLECARE MEDICAL Management
is comprised of hundreds of board-certified private-practice,
independent physicians. Collectively, our physicians have been
serving the Southeast area of Los Angeles and Northern Orange
County for decades, providing their medical expertise and passion
to improving the health of our communities.
The CASE MANAGEMENT ASSISTANT is responsible for the facilitation
of the authorization process and assists the Clinical Services Case
Managers with the Utilization and Quality Management processes.
This includes the collection of clinical data and the submission of
that data to licensed clinical staff for review and decision -
making. The Case Management assistant may not make decisions which
require clinical judgment.
PRIMARY RESPONSIBILITIES:
- Authorizes selected services per explicit criteria and
guidelines
- Collects data for clinical review and submits data to licensed
clinical services staff for decision-making
- Performs outbound patient calls per clinical pathway
- Facilitates patients appointments as directed by the case
manager
- Manages a case load of 100 - 150 low acuity patients that are
identified for population management by the case manager
- Presents cases to IDT for low risk members with case manager
oversight
- Provides feedback to Clinical Services Supervisor regarding
process improvement
- Performs data entry
- Prepares tracking reports
- Prepares denial letters
- Files / faxes
- Other duties as assigned
You'll be rewarded and recognized for your performance in an
environment that will challenge you and give you clear direction on
what it takes to succeed in your role as well as provide
development for other roles you may be interested in.
Keywords: UnitedHealth Group, Logan , Case Management Assistant, Executive , Logan, Utah
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