JOB PURPOSE

Responsible for assisting the oversight and day to day activities of the Care Management Department Care Management Assistants. The person holding this position will assist in delegating the responsibilities for carrying out the assigned duties and responsibilities of the Care Management Department Care Management Assistants.

KEY RESPONSIBILITIES

1. Implements partner relations practices necessary to establish a positive partner relationship and promote a high level of partner morale. 2. Responsible for recruitment and employment of Care Management Assistant staff, ensuring that they have the necessary qualifications to perform their job descriptions. 3. Participates in the development and implementation of an orientation program for each partner. 4. Serves as the liaison between Commercial contracted vendor and our customers. 5. Responsible for developing an in-service schedule for the Care Management Assistant staff that ensures that members of the department have skills necessary to ensure quality care. 6. Performs routine chart audits to ensure quality case management. 7. Provides back-up coverage. 8. Handles customer complaints expeditiously and according to policy 9. Ensure that Care Management Assistant staff is meeting company standards of customer service. 10. Maintains the privacy and confidentiality of protected health information, as well as sensitive information pertaining to other partners of PruittHealth 11. Facilitates clear information passage within and among departments involved. 12. Keeps supervisor informed of daily activities and issues. Purposes solutions to all issues. 13. Must get along with co-workers; maintain effective relationships with management staff, partners and the general public. 14. Must deliver exceptional customer service at all times. 15. May be responsible for a small caseload. 16. Performs other roles, administrative tasks and related duties as required by supervisor. 17. Must have timely, regular attendance. 18. Attend professional training as directed.

KNOWLEDGE, SKILLS, ABILITIES

• Knowledge of commercial insurance is fundamental. Knowledge of the Fundamentals of Case Management
• Ability to communicate effectively with payers, clients and providers essential.
• Must have working knowledge of computers, including Microsoft office programs.
• Understanding of state and federal regulations crucial.

MINIMUM EDUCATION REQUIRED

Bachelor's Degree Preferred - BSN preferred and or commercial managed care or case management organization

MINIMUM EXPERIENCE REQUIRED

• 3-5 years experience preferable in a commercial managed care or case management organization or post acute provider environment
• Equivalent combination of experience and training which provides the required knowledge, skills, and abilities.

Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference. We are eager to connect with you! Apply Now to get started at PruittHealth! As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

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