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Care Coordination Assistant - Waukesha Memorial Hospital - Full Time

Location:  Waukesha
Job Type:  Days - 1st Shift
Weekly Hours:  40

We Are Hiring:  Care Coordination Assistant - WMH - 1.0 FTE  

Schedule Details: Monday through Friday 8:00-4:30 Saturday coverage rotated every 4th week with  weekday off when scheduled for the Saturday, holiday rotation

 

Begin your story with ProHealth Care. ProHealth Care was recognized in 2020 by Forbes as the best-in-state employer for Wisconsin. The award is a testament to the more than 5,000 employees and providers who have spoken up about their love for their jobs and the work that they do. Enjoy our video series featuring our own employees sharing why they choose ProHealth Care and what they enjoy about working here.

 

At ProHealth Care, we offer a culture that's warm, welcoming, and vibrant. Additionally, we offer a generous benefits plan and resources to help you further your education. After all, it's the way you should be treated.

 

Culture is built every day, and we want you to be a part of this. If you're like us and are passionate about providing exceptional patient care, we'd like to meet you!

 

 

 

Job Summary

Coordinates the provision of clinical information to meet insurance payer notification and authorization requirements.  Facilitates and assists Care Management staff in obtaining pertinent clinical information to provide to third party payers in the ongoing concurrent and retrospective review of hospital admissions. Supports the care coordination and discharge planning process to assigned patients in the clinical area, under the supervision and direction of the RN Case Manager.  Assists the Care Management Staff and Supervisor to accomplish tasks required to meet departmental and organizational goals.   

Responsibilities

1. Demonstrates the Prohealth Care OUR SPARK Standards of Performance –an essential requirement of every ProHealth Care employee. Customers are defined as everyone you interact with in your role.
2. Provides a customer service oriented culture, including promptly answering/responding to phone calls, voicemails, emails and other requests in a professional manner. 
3. Reviews and processes payer requests for admission, concurrent, and retrospective reviews via hospital generated reports, facsimile or telephone requests. Documents case specific and ongoing requests for clinical review in the electronic medical record. Updates RN Case Manager to facilitate a timely response.   
4. Collaborates in the processing of requests for clinical reviews with Quality and Appeals RNs and/or RN Case Managers, to ensure pertinent clinical information is provided to the insurance payer in a timely manner. 
5. Collaborates with RN Care Management staff to ensure that the patient status type matches the level of care provided and documented, by scanning and entering EHR letters into the electronic medical record. 
6. Takes notes at Outlier and Department Meetings and prepares minutes efficiently and accurately.
7. Reviews and calls payers as necessary, updating status of Insurance approvals for the High Dollar and Insurance Authorization lists.
8. Assists in the update and maintainence of Care Management staff schedules.
8. Assists with data entry and scanning into the electronic medical record and AEOS, including authorizations, denials and appeals information.
9.  Maintains timekeeping records and functions as a Kronos Scheduler/Editor for Care Management staff.
11. Participates in scheduling discharge transportation needs for patients, such as transport to Skilled Nursing Facilities, Assisted Living Facilities or Home.
12. Actively supports the Case Manager with discharge tasks required, using AIDIN and other forms of communication. 
13. Prepares packets of medical record documents as needed to facilitate the discharge process. 
14.  Files paper forms into the patient's chart.
15.  Prepares Community DNR bracelets and forms for the RN to obtain signatures.     
16. Maintains current knowledge about regulations and policies that affect patient care.
17. Manages confidential information in accordance with ProHealth Care policies and procedures.  
18. Maintains personal growth and development through inservices, educational programs and workshops.
19. Maintains competencies of current computer systems utilized by within the department. 
20. Provides back-up for other Care Coordination and Departmental Assistants. 
21.  Keeps up to date with current departmental information by regularly reading emails and attending departmental meetings.
22. Assumes responsibility for all other duties as assigned.

Education

High School Diploma - or equivalent

Additional Requirements

  1. 2 – 3 years experience in Health Information Management (HIM), Business Office/ Billing, Patient Access, Skilled Nursing Facility or Inpatient Hospital Care or Care Management is required. 
  2. Excellent computer skills and proficiency in Microsoft Office, with the ability to learn EPIC and other software programs. 
  3. Excellent interpersonal skills and ability to interact and communicate with internal and external customers.
  4. Excellent organizational skills, time management skills and the ability to multitask.
  5. Ability to maintain flexibility with a positive attitude in a continuously changing environment.

What You Will Do:

Why Join ProHealth Care: 

We have nearly 5,000 dedicated clinical and non-clinical employees and physicians who work together every day to serve the health and well-being of our community. At ProHealth Care everyone contributes to the care our patients receive. And, everyone is treated with kindness and respect in our welcoming environment.

 

This Position Will Offer You:

  • Engaging and community focused culture
  • Competitive Salaries
  • Opportunity for professional career growth
  • Robust benefits including: Generous PTO; Choices in insurance; HSA; Tuition reimbursement; immediate 401K match; discounted tickets to various entertainment, social and sporting events

 

ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. *CA #LI

Do You Fit at ProHealth Care?

Here at ProHealth Care, we strive to be the best we can be, while continually improving the care we deliver. With patient care at the center of all we do, it is ingrained into our culture to attract the best and the brightest to ProHealth Care. We have a promise to our patients and employees: The way you should be treated. We live by this commitment and remain dedicated to creating a warm, safe and welcoming environment.


Nearest Major Market: Waukesha
Nearest Secondary Market: Milwaukee

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