Case Management Associate, Full Time, Days, 8:30am-4:30pm, Overlook Medical Center

Responsible for assisting with the continuum of care: performing tasks identified by the case management team for discharge planning, utilization management, and care coordination support. 


Principal Accountabilities:


1. As assigned, provide support to the RN Case Managers and Social Workers in completing routine post-acute care arrangements. This includes setting up routine post-acute services according to MD orders.
2. Completes tasks related to transfer of patients to post-acute care facilities including: a. Communication with facility related to bed availability, including use of case management electronic discharge system Sharing of internal referral information electronically or via fax. Assuring transfer of documentation/medical record complete d. Arranging transportation, confirmation of arrangements, and communication with families regrading transfer arrangements e. Maintaining and managing authorizations of post-acute settings, such as skilled nursing facilities, home care agencies, infusion service, durable medical equipment services, hospice, acute rehab, and long-term acute care facilities f. Demonstrating independence and proactive initiation of duties related to transfer of patients described above 
3. Assist the department in maintaining authorization or overcoming coverage denials by payers by providing medical records as demanded or required. 
4. Arrange medical transportation where required, including receiving insurance or medical group authorization. 
5. Prepare and fax necessary documentation/information to facilitate prior authorization 
6. Follow up on the above referrals by phone to ensure receipt of referral to intended company/facility and ensure all necessary information/documentation was provided. Receive and document authorizations requested.
7. Secures requested information for the healthcare team, patient, and/or family. This could include prescription availability, insurance requirements, and community resources 
8. Uses case management electronic system to support case management, utilization management and discharge planning process, as directed 

9. Interaction with patients/families on medical floor to complete/deliver/obtain signatures for IM and MOON letters. 
10. Supports the case management staff in tasks related to care coordination, discharge planning, and/or utilization management 
11. Assist with data collection 
12. Keeps team members updated with progress of assigned tasks. Escalates issues to case manager, social worker or leadership staff in a timely manner.
13. Documents accurately and thoroughly all transactions during the shift, according to department policy.

Required: 
1. High School diploma or GED equivalent


Preferred: 
1. Associate degree preferred
2. Hospital and/or insurance experience preferred.

3. Minimum two years' experience with a medical group, managed care organization, utilization management, hospital admitting, or medical nursing unit

At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Morristown Medical Center, Morristown, NJ
• Overlook Medical Center, Summit, NJ
• Newton Medical Center, Newton, NJ
• Chilton Medical Center, Pompton Plains, NJ
• Hackettstown Medical Center, Hackettstown, NJ
• Goryeb Children's Hospital, Morristown, NJ
• CentraState Healthcare System, Freehold, NJ
• Atlantic Home Care and Hospice
• Atlantic Mobile Health
• Atlantic Rehabilitation

We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners.

We have received awards and recognition for  the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• 100 Best Companies to Work For ® and FORTUNE® magazine for 15 years 
• Best Places to Work in Healthcare - Modern Healthcare
• 150 Top Places to work in Healthcare - Becker's Healthcare
• 100 Accountable Care Organizations to Know - Becker's Hospital Review
• Best Employers for Workers over 50 - AARP
• Gold-Level "Well Workplace": Wellness Council of America (WELCOA)
• One of the 100 Best Workplaces for “Millennials” G