Case Management Specialist

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Coordinate and execute administrative tasks that support the Case Management department.

• Take part in both annual and ongoing budget processes.

• Organize continuing care services for designated patient populations and facilitate patient transitions.

• Communicate and document clinical and financial details for Case Managers and Social Workers.

• Deliver and record mandated Observation and Medicare IMM/HINN letters.

• Receive and document requirements at the benefit and contract level.

• Address issues raised by providers and payors in collaboration with Case Management staff.

• Liaise with payors regarding billing, authorization, and service utilization.

• Complete state and federal forms pertaining to patient level of care.

• Oversee UAI filings and manage departmental accounts receivable and payable processes.

• Sustain the Case Management program and negotiate vendor contract reimbursements.

• Assist in strategic planning and business development efforts.

• Review and authorize department staff time and attendance.

• Maintain Case Management files and coordinate with the Foundation, auxiliary, and external vendors.

• Monitor operational budgets, fund distributions, capital requests, travel funds, and business expenses.

⛳️ Requirements

• A minimum of 2 years of relevant experience.

• High School diploma or GED.

• Capability to arrange Home Health, Durable Medical Equipment, Ambulance, Housing, Skilled Nursing Facility, and other continuing care services.

• Proficiency in communicating and documenting precise clinical and financial information.

• Competence in completing state and federal forms related to patient level of care.

• Ability to manage UAI filings along with accounts receivable and payable functions.

• Skill in monitoring Case Management programs and vendor contract reimbursements.

• Ability to review and approve staff time and attendance and process pay adjustments.

• Capability to oversee operational budgets, capital requests, travel funds, and business expenses.

🏝️ Benefits

• Access to world-class healthcare.

• Opportunities for professional development.

• Commitment to Equal Opportunity employment.