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Company: MedStar Health
Location: Rosedale, MD
Career Level: Entry Level
Industries: Not specified

Description

About the Job

Department: Physician Practice - Utilization Case Management

Schedule: Monday - Friday, 8;30am - 5pm

Address: 5233 King Ave Baltimore, Maryland 21237  

 

 

 

 General Summary of Position
Serves as a member of the Quality team capable of supporting an array of care coordination administrative processes and services for Medicare FFS beneficiaries attributed to practices that the Care Transformation Organization (CTO) supports. Responsible for the care coordination of Medicare beneficiaries attributed to a medical practice(s). Serves to support the Lead Care Manager and the CTO's interdisciplinary care management team.

Primary Duties and Responsibilities

 

  • Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Builds and maintains relationships with Lead Care Manager(s) interdisciplinary care team and community resource partners.
  • Ensures daily telephonic patient communication to help to close gaps in care and provide up-to-date healthcare information helping to facilitate the members understanding of his/her health status using available reports including quality m page and HIE CRISP to ensure relevant medical history/encounter are accessible in EMR.
  • Facilitates ongoing communication by participating in huddles hosting regular conference calls in-person meetings or coordinating regular email updates to ensure alignment of activity discuss new developments and exchange information.
  • Enters data into power forms and maintains timely and accurate documentation in the EMR MedConnect.
  • Processes telephone inquiries and communicates knowledge of policies and procedures. Projects a positive image on the telephone to internal/external customers. Represents the best of MedStar Accountable Care at all time and to all customers.
  • Runs monthly reports compiles data for reporting and identifies members with gaps in care.
  • Provides support in coordinating and managing referrals of care for program participants to support program goals.
  • Provides support to Lead Care Managers as needed.
  • Provides support for the Patient Family Advisory Meetings by contacting patients sending invitation letters initiating reminder calls arranging transportation etc.
  • Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.
  • Performs other duties as assigned.

Minimal Qualifications
Education

  • High School Diploma or GED required

Experience

  • 3-4 years Work experience including 1 or more years of proven case management project management and population health coordination experience. required and
  • Experience with data collection and reporting and community outreach experience preferred and
  • Familiarity with the local area and/or population health workforce integration. required and
  • Experience working in an ambulatory setting preferred

Licenses and Certifications

  • Certified Medical Assistant (CMA)-AAMA Valid Maryland Medical Assistant license required

Knowledge Skills and Abilities

  • Effective verbal and written communication skills.
  • Excellent interpersonal and customer service skills especially serving geriatric patients.
  • Strong community engagement and facilitation skills.
  • Advanced project management skills.
  • Flexibility and the ability to work autonomously as well as take direction as needed.
  • Cultural competency.
  • Proficient computer skills along with experience using Microsoft applications-Word Excel etc. and familiarity with entering data in an electronic medical record (EMR).

This position has a hiring range of

USD $22.48 - USD $39.75 /Hr.


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