"Alerted.org

RESPONSIBILITIES

Effective Date: 12/25

I. JOB SUMMARY:

• Supports Social Work (SW), Case Management (CM), and Utilization Management (UM) staff, as well as area leadership, in coordinating patient discharge and managing internal and external resources.

• Key responsibilities include assisting with resource management, communication with department and system-wide staff and external parties including payors, assisting with discharge arrangements, and providing departmental administrative support.

• Supports the Utilization Management (UM) team with emergency, observation and inpatient visits. Responsible for processing and documenting clinical requests, authorizations/approvals and denial communication from payors via fax, email or phone.

• Collaborates with all members of the UM team or interdependent departments (i.e. Patient Access, Billing, etc.) to ensure unnecessary delays in patient care, discharge or billing.

II. TYPICAL PHYSICAL DEMANDS:

A. ESSENTIAL FUNCTIONS:

• Seeing. Hearing. Speaking. Finger dexterity.

B. MANUAL MATERIAL HANDLING:

• Infrequent: N/A

• Occasional: N/A

• Frequent: N/A

• Constant: N/A

C. NON-MANUAL MATERIAL HANDLING:

• Infrequent: Stoop/Bend. Reach: shoulder level. Reach: above head.

• Occasional: N/A

• Frequent: Stand. Sit. Walk.

• Constant: N/A

III. TYPICAL WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:

A. EDUCATION:

• Associate's degree required, preferably in a health-related field, or social work; or two (2) years work experience in a health related field or social services may be substituted for the educational requirement.

• Bachelor's degree preferred.

B. CERTIFICATION AND LICENSURE:

• No certification and/or licensure requirement.

C. EXPERIENCE:

• Prior experience in health care, hospital setting, and/or Patient Financial Services.

Equal Opportunity Employer/Disability/Vet