Case Management Extender
The Case Management Department is an integrated model with registered nurse and social work case managers. The case managers work together to assess patient and family needs across the hospital. They work collaboratively with all disciplines, patients, and families to achieve mutually agreed upon care goals. Case managers facilitate multi-disciplinary rounds to effectively transition patients safely to the next level of care and manage throughput initiatives. Our emergency department is staffed 24/7 with case managers and we have a dedicated observation management team.
Presents on site to support all Case Management team members to achieve departmental goals by completing tasks related to discharge planning, billing and financial regulations, and patient facing interactions for enhanced patient experience. Utilizes departmental tools and resources to organize and prioritize daily responsibilities including, but not limited to: (1) timely delivery and documentation of "Important Message," "MOON," and "OON" notices to patient or representative, (2) coordination of post-acute placements, transportation, home healthcare, and various community services which ensure a safe, appropriate patient discharge (3) Financial support responsibilities: payer communication, certification, authorization, admission, and concurrent denial avoidance, (5) Providing complete clinical information to a continuum of post-acute providers with provider follow-up to ensure receipt of documents (6) Supports HIM and Patient Accounts by ensuring timely, accurate, and complete data entry in multiple information systems/data bases, such as, removing accounts from the Do Not Bill work queue, etc. Brings workflow barriers or issues to the attention of CM leadership in an expedient manner. Maintains excellent working relationships with payers and post-acute providers. Ensures that flow of information, including delays, to CM Clinicians (ie RN Case Managers, Social Workers, Utilization RN's) is timely and accurate. Demonstrates ability to multitask and exhibits attention to detail. Responsible for performing job duties in accordance with the mission, vision, and values of Tampa General Hospital.
* High School Diploma or GED required. Associates degree in Social Work or related field is preferred.
* Two (2) years' experience in utilization management and hospital case management/ social service and/or managed care performing discharge planning, interfacing with insurance companies and/or utilization review may substitute for the degree. Medical terminology required.
* Must be computer literate, have experience with internet browsers, and familiarity with Microsoft Office.