Remote
Assist Case Manager(s), Specialist, Supervisor & Manager in assigned area of responsibility, including compiling information (open & close inpatient cases), fax authorization letters to providers, including sending denial letters and keeping records. Provide and coordinate information with outside agencies.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Comply with CM policies and procedures. Annual review of selected CM policies
- Provide support to case managers on day-to-day activities
- Sort, stamp and distribute incoming faxes
- Create authorization/tracking numbers for all discharge planning admissions
- Obtain in-patient discharge orders, clinical documents and follow-up discharge plan dates
- Communicate with Hospitals, SNF, Acute Rehab & other admitting facilities on status/updated discharge plan
- Provide authorization(s) for services requested on discharge (i.e., DME, Home Health, others)
- Update authorization notes to include the status of tracking number
- Notify admitting facility case management team & medical group case manager(s) all discharge needs of patient(s) status
- Assist in researching problems that occurs in case management department in a timely fashion
- Responsible for follow-up and returning department calls
- File and scan hospital records as assigned
- Report to CM Lead 3, supervisor & manager on activities or problems occurring throughout the day
- Attend to provider and interdepartmental calls in accordance with exceptional customer service
- Demonstrate professional responsibility in the role of Discharge Planner
- Coordinating/Managing all discharges from In Patient and SNF. Handles at least 15-40 discharges a day
- Arranging/Coordinating all D/C plan to Home Health, Hospice, IV and DME
- Follow up call to Home Health admitted on a weekends
- Creating/approving Authorizations/ cases for Home Health, Hospice, DME and IV
- Responsible for reviewing TARS 30-70 a day (Treatment Authorization Request) and approving it
- Doing on-call after office hours/weekends when needed a coverage
Qualifications
- High School Graduate or equivalent
- A minimum of 2 year experienced in managed care environment to include but not limited to an IPA or MSO preferred
- Knowledge of medical terminology, RVS, CPT, HPCS, ICD-9 codes
- Proficient with Microsoft applications’ and EZCAP
- Good organizational skills
- Good verbal and written communication skills
- Must have the ability to multitask and problem solve in a fast pace work environment
You're great for this role if:
- Punctuality, precision with details, creativity, etc. would be helpful for this position
- Ability to follow directions and perform work independently according to department standards
- Able to function effectively under time constraint
- Able to maintain confidentiality at all times
- Willingness to accept responsibility and desire to learn new task
- Ability to comply and follow company policies and procedures
- Must be a strong team player, punctual and have excellent attendance record
Environmental Job Requirements and Working Conditions
- Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The position is located at 1600 Corporate Center Dr, Monterey Park, CA 91754.
- This role will require visiting patients in our partnered hospitals.
- The target pay range for this role is between $20.00 - $25.00 per hour. The salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditioos), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
About Astrana Health, Inc.
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
