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Care Management Associate - La Jolla - 126209

University of California - San Diego Medical Centers
United States, California, San Diego
Jan 10, 2024
This posting will remain open until a successful candidate has been identified. UCSD Layoff from Career Appointment: Apply by 10/27/2023 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Special Selection Applicants: Apply by 11/07/2023. Eligible Special Selection clients should contact their Disability Counselor for assistance. DESCRIPTION In collaboration with the RN Case Manager, patient/family, healthcare team and payors, the Care Management Associate coordinates the care services for assigned patients for an episode of illness or treatment as defined by the Case Manager. Promotes the effective utilization of resources using current knowledge and awareness of community resources to achieve optimal care. This includes assisting with discharge planning, insurance verification, and authorization obtaining necessary resources, sending referrals, making follow-up medical appointments, and appropriate documentation of activities in all required computer systems. Other related duties as assigned. MINIMUM QUALIFICATIONS Three (3) years of Care Management support or related experience in a healthcare setting. Extensive and demonstrated knowledge of Government and Commercial insurance plans. Thorough knowledge and understanding of managed care plans. Proven ability to utilize payor and government website to access and interpret health plan benefits packages and make determinations. Demonstrated experience with referral authorization process. Experience with MS Office. General understanding of medical terminology. PREFERRED QUALIFICATIONS High level of customer service experience. Experience in an acute care hospital setting. Experience with Epic or other EMR systems. Experience arranging post-acute services and equipment for patients. Experience with Allscripts referral system. Experience in a hospital admitting department. Experience with registration and/or billing computer software programs. SPECIAL CONDITIONS Variable work hours and locations. Willing to work overtime as required. Must be able to work various hours and locations based on business needs. Employment is subject to a criminal background check and pre-employment physical. Pay Transparency Act Annual Full Pay Range: $53,077 - $65,960 (will be prorated if the appointment percentage is less than 100%) Hourly Equivalent: $25.42 - $31.59 Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).