Case Management Specialist

🔥 0 minutes ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $21 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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👻 Ghost score 0%

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Inova Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Inova Health is Northern Virginia’s leading nonprofit healthcare provider, offering world-class clinical excellence to communities with a warm, human touch. With over 22,000 team members, Inova serves more than 2 million individuals annually across various specialties, including cancer, neurology, and gynecology. The organization is recognized for excellence by various authoritative bodies, including the Centers for Medicare and Medicaid Services and U. S. News & World Report. Their comprehensive services include hospital care, emergency services, outpatient care, and more, making them a vital healthcare partner for many.

📋 Description

• Coordinate and perform administrative activities supporting the Case Management department • Participate in annual and ongoing budget processes • Arrange continuing care services for assigned patient populations and support patient transitions • Communicate and document clinical and financial information for Case Managers and Social Workers • Deliver and document mandated Observation and Medicare IMM/HINN letters • Receive and document benefit and contract-level requirements • Address provider and payor issues with Case Management staff • Communicate with payors regarding billing, authorization and service utilization • Complete state and federal patient-level-of-care forms • Manage UAI filings and departmental accounts receivable/payable functions • Maintain the Case Management program and negotiated vendor contract reimbursement • Support strategic planning and business development initiatives • Review and approve department staff time and attendance • Maintain Case Management files and liaise with Foundation, auxiliary and external vendors • Monitor operational budgets, fund disbursement, capital requests, travel funds and business expenses

🎯 Requirements

• 2 years of relevant experience • High School or GED • Ability to arrange Home Health, Durable Medical Equipment, Ambulance, Housing, Skilled Nursing Facility and other continuing care services • Ability to communicate and document accurate clinical and financial information • Ability to complete state and federal forms related to patient level of care • Ability to manage UAI filings and accounts receivable/payable functions • Ability to monitor Case Management programs and vendor contract reimbursement • Ability to review and approve staff time/attendance and submit pay adjustments • Ability to monitor operational budgets, capital requests, travel funds and business expenses

🏖️ Benefits

• World-class healthcare • Professional development opportunities • Equal Opportunity employment