Case Management Assistant-PACE

Job Summary : The Case Management Assistant-PACE collaborates with Case Managers and Social Workers in assisting with the continuum of care and discharge planning. Communicates clinical information, referrals and coordination of insurance review. Collaborates with the Business Office for identification of eligibility, and coverage. Supports medical on-site reviewer functions, assists with authorization requests, and supports the denials and appeals process. Functions under the direction of a Case Manager with minimal supervision, takes responsibility for professional growth, and assists in the coordination of participant placements, ordering of durable medical equipment and coordinating care transitions. Performs other duties as needed. Performs other duties as needed.

Education and Experience : Associate's Degree in related field preferred. Minimum three years experience with a medical group, managed care organization, utilization management, hospital admitting, or medical nursing unit required. Hospital and / or insurance experience preferred.

Knowledge and Skills : Working knowledge of Medi-Cal, CCS, CMS and commercial regulations and managed care; Knowledge of state managed health plans and contracting. Able to read; write legibly; speak in English with professional quality; use computer and software programs necessary to the position; Operate / troubleshoot basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; able to demonstrate positive customer service skills; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; work independently with minimal supervision; perform basic math functions; manage multiple assignments effectively; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail; maintain confidential records and correspondence. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place; see adequately to read computer screens, medical records, and written documents necessary to position.

Licensures and Certifications : Valid driver's license required. Medical Assistant Certification preferred.

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.