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Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

+ The Case Management & Social Work Assistant serves as an operations/coordinating/analytic role for the Department of Case Management & Social Work. The position works under the direction of the RN Case Manager or Social Worker to provide assistance with the coordination of post hospital care and service arrangements, post-acute placement insurance authorizations utilizing various information portals, the delivery of regulatory compliance documents to patients (The Important Message from Medicare, Patient Choice forms, MOON, etc, ) and other duties to support the operations of the department to facilitate discharge efficiency and reduce the length of stay.

Responsibilities:

+ Provides support and assistance to the Case Managers and Social Workers

+ Answers phones in a prompt and courteous manner directing calls and messages to the appropriate individual

+ Collaborates with Business Office to ensure accuracy of patient information. Communicates updated information to all appropriate parties in a timely manner.

+ Collects, copies and transmits pertinent patient demographic and clinical information required to complete referrals for post-acute care and/or placement, as directed by the Case Manager or Social Worker. Documents per department procedure in EPIC.

+ Communicates timely, relevant and accurate information to the Case Managers and Social Workers involved in their assigned patients’ care. Documents per department procedure in EPIC

+ Documents all approvals, denials, updates and other pertinent information in relevant applications for post-acute services.

+ Effectively communicates all forms of clinical information to all payers when requesting authorization for post-acute services.

+ Ensures payer and customer satisfaction through effective communication and positive customer service skills at all times.

+ Keeps supervisor informed of changes in workload.

+ Keeps supervisor informed of Third-Party Payer patterns and trends.

+ Maintains confidentiality of patient information.

+ Maintains routine and frequent communication with Case Managers/Social Workers on the status of their referral requests and other assigned tasks.

+ Obtains authorization for appropriate level of post-acute care from third party payers.

+ Obtains payer authorization and provider information for Home Care, Durable Medical Equipment (DME), transportation, infusion services and post-acute services/providers, next level of care.

+ Proactively communicates any change in payer information to Supervisor/Manager and Business Office and documents changes appropriately.

+ Provides updates to the Case Manager or Social Worker if there are “pending” post-acute service approvals and additional clinical information is needed for the third-party payer to make a determination regarding post-acute services.

+ Provides prompt feedback regarding adverse determinations and denials for post-acute services to appropriate staff.

+ Responsible for meeting insurer timeframes regarding requests for post-acute services.

+ On a daily basis and throughout the shift, organizes and creates a priority work list to ensure patients’ discharge expectations are met. Works with Case Managers and Social Workers to prioritize competing requests.

+ Coordinates and arranges transportation, Durable Medical Equipment and community services as directed by the Case Manager or Social Worker. Documents per department procedure in EPIC.

+ Maintains working knowledge of agency and community resources as required.

+ Obtains patient signatures on the Important Message from Medicare within 48 hours of patient discharge

+ Delivers MOON form and MCSN form to patients as requested by CM/SW.

Credentials:

+ H.S. Diploma/GED (Required)

+ 2+ years Prior healthcare experience

+ Associate of Arts or Science

+ Business or Healthcare

+ Bachelor of Arts or Science

+ Business or Healthcare

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

REQNUMBER: 283347