The Brown and Toland Care Management Program collaborates with Brown & Toland Physicians to provide the right care at the right time to meet the needs of its members. The Care Management program actively engages members to address health concerns, coordinate care, and make informed choices. As part of an interdisciplinary team the Care Management Coordinator will contact patients to gather information and assist with care coordination among medical providers, social and health services. Accurate data entry and tracking and organization of care management department tasks are essential duties of the position.
Responsible for obtaining and accurately entering data for authorizations, assessments and other data elements to track programmatic and member activity.
Conduct initial telephone interview for patients referred for post discharge follow up.
Respond to with excellent customer service to information and assistance requests from patients, their families, physicians and internal customers.
Communicate appropriately and timely all issues that require escalation to supervisor of other member of Care Management team.
Communicates regularly with contracted Health Plans, Behavioral Health organizations, Brown & Toland medical director, and care management team and any other provider when appropriate, e.g. readmitted members, California children’s services or health plan audits.
Responsible for scheduling, confirming patient appointments post discharge and escalate issues to the clinical team.
Responsible for screening for care management programs.
Provides administrative support to the Care Management team such as accurately entering authorizations for home health, Durable Medical Equipment, social services identification, and member targeted mailings.
Coordinates with other departments like Referral Services, Health Care Analytics, Claims, Quality Management activities.
Responsible for all incoming care management related questions.
REQUIRED EXPERIENCE AND SKILLS:
Two to three years previous Administrative support or medical assistant experience.
Must possess basic computer skills and the Microsoft suite of software.
Must demonstrate accurate documentation and be extremely detailed oriented.
Ability to work telephonically with our stakeholders educating them on following established processes and procedures for obtaining authorizations or assisting in answering other questions regarding eligibility or benefit coverage.
Must be willing to show that customer service is a primary function in this position.
Working knowledge of medical terminology, coding and managed care concepts.
Strong verbal and written communication skills and analytical abilities.
Ability to use independent judgment.
Must have a High School diploma or equivalent. Some college preferred.
Brown & Toland Physicians - 8 months ago
Brown & Toland, based in San Francisco, is an independent practice association (IPA) of more than 850 community physicians serving...