Care Management Resource Center Specialist

🔥 4 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Cleveland Clinic

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Cleveland Clinic is a not-for-profit, multispecialty academic medical center located in Cleveland, Ohio. Founded in 1921, it integrates clinical and hospital care with research and education, earning a reputation as one of the largest and most respected hospitals in the country. The health system includes multiple facilities across Northeast Ohio and other locations globally, providing a wide range of specialized services such as cancer care, women's health, dermatology, and cardiovascular care. Cleveland Clinic is accredited by The Joint Commission, which underscores its commitment to high standards in healthcare delivery.

📋 Description

• Support the Transitional Care Coordinator and Inpatient Social Worker with specified non-clinical work. • Initiate contact with payers to facilitate precertification for transfer to post-acute facilities, provide clinical documentation and ensure timely follow up calls. • Initiate contact with post-acute agencies, provide updates as requested and facilitate placement. • Facilitate 7000 forms by Healthcare Electronic Notification System (HENS). • Place and close referrals in AllScripts Care Management. • Handle calls from commercial payor case managers with questions regarding admitted patient’s discharge plans. • Manage post-acute pre-cert process for commercial insurance patients needing pre-cert to post-acute facilities. • Provide necessary verbal and electronic communication to and from care management staff, serving as a liaison between hospital personnel and the various agencies. • Serve as a central hub communicator for discharge plan information. • Completes data tracking and collection to assist with the identification of routine statistics and problems or trends.

🎯 Requirements

• High School Diploma or GED • Three to five years of current administrative/clerical experience working in healthcare or a related field • Fluency in medical terminology • Computer literacy • Excellent verbal and written communication and organization skills

🏖️ Benefits

• Our outstanding, comprehensive offerings are an investment in your health, well-being and future.