• Care Manager Assistant

    PruittHealth (Norcross, GA)


    JOB PURPOSE:

    The Care Manager Assistant will provide support to assigned facilities to ensure communication and authorization of medically necessary services provided in the post-acute setting with oversight from Department Manager, RN Case Manager or LPN Care Manager. In addition, may be asked to provide a wide range of administrative and clerical support to the Care Management Department.

    KEY RESPONSIBILITIES:

    The Care Management Assistant will provide support to assigned facilities to ensure communication and authorization of medically necessary services provided in the post-acute setting with oversight and support from Department Manager, RN Case Manager and LPN Care Manager.

    KNOWLEDGE, SKILLS, ABILITIES:

    • Reasonable demonstration of the ability to understand CMS and Commercial Insurance requirements to ensure compliance with regulations and standards.

    • Must have basic knowledgeable of medical necessity review guidelines for commercial, Medicare, and Medicaid insurance products.

    • Demonstrates the ability to communicate effectively via phone and email with our internal and external customers.

    • Strong organization and ability to multitask is essential to success in this role.

    • Identifies and escalates issues that affect the managed care process from a compliance and/or reimbursement standpoint.

    • Escalates all cases that requires the assistance/approval of a Department Manager, RN Case Manager or LPN Care Manager, for example single case agreements.

    • Must be proficient in the use of computer applications for daily use

    • Must be a self-starter and be able to work independently

    • Highly proficient in Microsoft Word, Intermediate Excel and Outlook required

    MINIMUM EDUCATION REQUIRED:

    High School Diploma

    MINIMUM EXPERIENCE REQUIRED:

    2 years work experience

    **ADDITIONAL QUALIFICAITONS** (Qualifications Preferred):

    • Post-acute and/or healthcare industry experience is preferred

    **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._