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Role Description

The Case Manager Assistant assists the RN Case Manager in performing necessary functions using the Case Management process in order to meet the needs of MedWatch, LLC customers and consumers. This includes, but is not limited to:

• Authorization of services
• Review of treatment plans for medical necessity
• Standards of care
• Ongoing communication with all members of the health care team

The Case Manager Assistant performs all functions under the direct management and supervision of the RN Case Manager. This individual is expected to accurately communicate in both Spanish and English to service customers and satisfy the responsibilities outlined in this job description.

Qualifications

• Licensed Practical Nursing Education preferred
• Basic computer skills

Requirements

• Licensed Practical Nurse or Medical Assistant/Nursing Assistant Certification (current active and unrestricted, in current state of practice and residence, within the United States or its territories)
• 5 years of varied clinical experience preferred, or three years in a specialty field
• Basic computer skills
• Good organizational skills and time management
• Excellent verbal and written communication skills
• Ability to handle difficult situations tactfully and diplomatically
• Effective problem solving and decision-making skills
• Strong computer skills with proficiency in MS Office Suite products (Word, Excel, PowerPoint)

Benefits

• Pay differential for Bilingual - Spanish speaking requirement
• Salary range for this position is from $23 to $27 per hour

Duties and Responsibilities

• Must speak fluent English and Spanish with strong reading and writing abilities in each language
• Practice within the scope of licensure under the direct supervision of the RN Case Manager
• Review all medical data to update a Case Management plan
• Make contact with the payer office to understand any benefit constraints
• Contact medical care providers and equipment vendors to verify medical necessity
• Make care arrangements for quality patient care according to patient needs and physician’s orders
• Be aware of alternative treatment possibilities for patient wellness goals
• Become familiar with community resources and funding sources
• Maintain case documentation in the computer system
• Prepare timely reports to the payer detailing case actions and results
• Maintain billing as appropriate in the computer system
• Continue contact with providers and patients across the continuum of care
• Negotiate with providers to maximize medical benefits available to the patient
• Act upon awareness of non-medical issues affecting patient safety or welfare
• Consult with the Case Manager regularly and keep the Director of Case Management informed
• Adhere to all company policies as stated in the employee handbook
• Participate in the Quality Management Program
• May be responsible for additional duties not listed in this job description

Work Environment / Physical Demands

This position is in a typical office/home office environment which requires:

• Prolonged sitting in front of a computer
• Hand-eye coordination and manual dexterity sufficient to operate standard office equipment

We are an Equal Opportunity Employer, including disability/veterans.