Case Manager

Department: PEDS

Salary Range: $25.00 – $31.00 (DOE)

Summary

The Case Manager is responsible for providing comprehensive case management for patients. Receives referral requests from physicians and medical assistants, calls and responds to patients’ needs in person or by telephone. Connects patients to resources and medical care, as directed by medical team.

Essential Duties/Responsibilities:

1.  Responsible for completing the referral process including:

·  Obtain referral from provider in timely manner

·  Obtain authorization where applicable

·  Schedule appointments

· Communicate appointment information to patient, utilizing cultural liaisons, or language line as needed.

· Communicate referral/authorization information and pertinent medical information to the specialty provider. Schedule specialty appointments utilizing all resources available for the patient.

· Follow-up with the patient and specialty provider to document that patient has kept appointment, communicating outcomes to PCP.

·  Obtain the consult/progress reports from the specialty provider.

·  Appropriate documentation in the patient medical record (EMR- PM – I2I)

·  Anticipating barriers to care & to accessing resources, and proactively finding solutions.

· Additional tasks may be added as needed, to facilitate patient access to services and resources.

2.  Track all referrals in the designated logs

3. Meet or discuss with patients any and all aspects of the referral process as needed or requested by the medical team. This may include counseling the patient regarding the cost of a referral under provider direction.

4. Patient communication in person, by telephone and/or by mail.

5. Maintain accurate lists of specialists/providers by funding source and other community resources as approved by the Medical Director and/or supervisor.

6. Act as liaison between patient, clinic/providers, specialty care providers, health plans/funding sources and community resources.

7. Other duties as assigned.

Job Requirements

Education: High School Diploma or GED.

Certification required: Medical Assistant Certificate, Valid CPR card.

Experience: 1-2 years experience in physician office or hospital setting as a medical assistant, patient services representative, or similar experience. Strong track record of identifying barriers to care for patients, and helping them overcome such barriers.

Verbal and Written Skills to perform the job: Bilingual (English/Spanish). Ideally also Haitian Creole but flexible on this. Familiarity with basic word processing, spreadsheet, and database applications. Accurate keyboarding skills.

Technical knowledge and skills required to perform the job: Excellent verbal, written and interpersonal communication skills and the demonstrated ability to work with diverse individuals and groups. Demonstrate high levels of self-initiation and direction. Knowledge of communities we serve. Knowledge and experience working in medical settings and interacting collaboratively with medical teams. Skill in analyzing situations and making timely decisions.

Physical and Mental Requirements: Work involves sitting, talking, hearing, using hands to handle, feel or operate objects, tools, or controls, and reaching with hands and arms. The employee may be required to push, pull, lift, and/or carry up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

La Maestra Community Health Centers is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation or belief.