Care Management Assistant HHC

11200 IL Home Health Divisional - Case ManagementFull timeYes40

hybrid, in the office once per week, Mon-Friday 830-5

Major Responsibilities:

• Monitor Task Report, respond to request from billing, insurance verification and service office.
  •     1)Obtain documentation for Prior Approval Request on patients with HFS insurance.
  •     2)Contact Clinical Manager on any urgent issues or patients were documentation does not support projected number of visits.
• Track clinical updates for timely submission of written documentation to Enterprise Care Managers (ECM)
  •     1)Identify ECM through Active Advice
  •     2)Submit appropriate documentation to ECM upon patient discharge from Home Health.
  •     3)Submit additional documentation upon request to ECM for AdvocateCare patient population.
• Verification of authorized visits versus visits made and visit frequency on specified payers. Reporting of final visit numbers to external case manager.
  •     1)At specified times (i.e. discharge and recertification), review and match actual visits to authorized visits, coummunicate visit summary to external case manager.
  •     2)Notify internal Case Manager of any discrepanies.
• Obtain Plan of Treatment and/or Supplemental Orders to support request for Prior Approval on patients with HFS health plan.
  •     1)Track supplemental orders to obtain prior authorization from HFS on ALL therapies.
• Communicate authorized visits to contracted vendors on HFS patients. Monitor contracted therapy vendors for over utlization and unauthorized services.
• Other Duties as assigned
  •     1)Assist Case Managers with documentation process as needed

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Pay Range

$18.50 - $30.60

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program