1-3 years of experience
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Employment Type:
Full time
Job Category:
Health Care Provider
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Job Description

Under the supervision of the RN Case Manager, the Case Manager Assistant performs essential duties to the provision of Case Management for Hoag Hospital and its affiliates (the “Organization”). The Case Management Assistant implements patient discharge plans, assists with coordination of clinical utilization review, and makes third party payor notifications in support of nursing and social work staff on the case management team. The Case Management Assistant also interacts with representatives from insurance companies, health maintenance organizations, home care agencies, skilled nursing facilities, durable medical equipment companies, and transportation agencies.
The Case Management Assistant displays and practices a work-style reflecting the mission, vision and values of the Case Management team, as well as the Organization. Participates in the continuous quality improvement process. Maintains a working knowledge of departmental standard operating procedures, including the use of specialized instrumentation, Quality Control requirements, and preventive maintenance.


Essential Functions
ï‚· Implements patient discharge plans prepared by social work and nursing case management team members. This is done by arranging with home care agencies, skilled nursing facilities, durable medical equipment companies, and/or transportation agencies for placement, logistics, and equipment, and by interacting with patients and their families.
ï‚· Contacts third party payors to confirm authorization for services.
ï‚· Assists Case Manager in collecting data related to patient outcomes and auditing data for accuracy.
ï‚· Prepares documents and reports required for utilization reviews by third party payors and other internal and/or external groups.
ï‚· Documents activities and progress in medical charts and computer billing/utilization systems.
ï‚· Inputs clinical information into computer database.
ï‚· Clinical Care: Ensure that quality patient care is delivered to all patients on a 24-hour basis, and the unit is maintained in accordance with professional and regulatory standards and the philosophy and goals of Hoag.
ï‚· Perform other duties as assigned.

Education, Training and Experience
Required: One year acute care, home health or skilled nursing facility experience. High-School graduate or equivalent.
Preferred: Case Management Assistant Certification. Two years of college-level education in healthcare or related field.

Skills or Other Qualifications
Required:  Self-directed individual with ability to prioritize multiple tasks and meet deadlines, excellent attention to detail, and maintain a high level of work quality.  Strong team player with excellent oral, verbal and presentation communication skills. Proven ability to interface with all customer levels (physicians, Organizational staff, insurance companies, patients and family members).  Working knowledge of Microsoft Office Suite, including Outlook, Word, Excel, and PowerPoint, plus healthcare database systems. Basic knowledge of medical procedures and terminology.  IT competence for Microsoft Office, and able to learn systems rapidly.
Preferred: Qualified bilingual or multilingual candidates.

About Hoag Memorial Hospital Presbyterian

Located on the bayside bluffs overlooking Newport Beach, Hoag Memorial Hospital Presbyterian stands atop the list of the finest medical facilities in Southern California. Fully accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and designated as a Magnet hospital by the American Nurses Credentialing Center (ANCC), Hoag Memorial Hospital Presbyterian is a 511-bed acute care, not-for-profit hospital that provides a quality work environment and quality lifestyle. This unique combination provides an enriching environment like no other.

A quality work environment and quality lifestyle enables our nurses to chart a satisfying course for every area of their lives - professional, family, friends and personal pursuits. Along with Hoag's commitment and family-oriented approach to providing the highest quality patient care, there is an indisputable pride in the way we fulfill our healing mission.

We invite you to be a part of the dynamic and rewarding career opportunities available at our top-rated medical facility, while enjoying the added luxury of the renowned Southern California lifestyle.

Take a look inside and we believe you'll see why there is no place like Hoag.

View available openings at Hoag Memorial Hospital Presbyterian


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About Hoag Memorial Hospital Presbyterian

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Learn more about Hoag Memorial Hospital Presbyterian

Learn more about Hoag Memorial Hospital Presbyterian

This company profile was created by AfterCollege and is about Hoag Memorial Hospital Presbyterian. This page is not endorsed by or affiliated with Hoag Memorial Hospital Presbyterian. For questions regarding company profiles, please email: care@aftercollege.com.