Utilization Management Assistant Jobs in Durham, NC

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The Care Management Assistant serves as a key administrative partner to Care Management leadership, providing comprehensive support to Regional Directors, Managers, and departmental teams. This role is responsible for coordinating a wide range of administrative functions that contribute to the efficient operation of the department, including calendar management, meeting coordination, travel arrangements, budget and payroll support, contract administration, and maintenance of personnel records.
In this role, the Care Management Assistant helps facilitate effective communication and workflow across the department by scheduling meetings and interviews, reserving conference space, coordinating catering services, registering staff for conferences and webinars, and managing incoming and outgoing correspondence. The position also supports leadership through the preparation, formatting, and distribution of documents, reports, presentations, spreadsheets, and other business materials.
The Care Management Assistant plays an important role in supporting departmental projects and initiatives by attending complex meetings, documenting discussions and action items, transcribing meeting notes, and assisting with special projects as assigned. Through exceptional organizational skills, attention to detail, and a commitment to customer service, this position helps ensure seamless day-to-day operations and supports the overall success of the Care Management team.
Responsibilities:
1. Huddles: The Care Management Assistant participates in regular huddles with the care management team to discuss patient cases, care plans, and address any challenges or concerns.
2. Prioritized work: The Care Management Assistant helps prioritize the workload by assessing the urgency and importance of various tasks. They collaborate with the care management team to ensure that high-priority tasks are addressed promptly.
3. Delegated tasks assigned by clinician: The Care Management Assistant assists in the delegation of tasks assigned by the clinician, utilization manager, social worker, or care manager. They work closely with the healthcare team to ensure that delegated tasks are properly completed. Delegated tasks may include payer communication to facilitate optimal reimbursement and timely approvals for necessary care and services.
4. Patient care transitions: The Care Management Assistant conducts activities, as assigned, to ensure patients are engaged in their care and have the necessary resources and support. They may also assist in scheduling appointments and coordinating transportation as needed.
5. Assists patients in navigating the health care system: The Care Management Assistant provides guidance and support to patients in navigating the complexities of the health care system. This includes explaining health insurance coverage, helping patients find appropriate healthcare providers and services, and assisting in the coordination of care between different healthcare providers and facilities.
6. Resource Procurement: The Care Management Assistant assists in the procurement of services and/or equipment relevant to their assigned department's protocols.
7. Facilitates documentation for care transitions: The Care Management Assistant facilitates the documentation required for care transitions, such as transcribing forms like FL-2 (Level of Care Determination) and PASRR (Preadmission Screening and Resident Review). They assist with necessary paperwork in an accurate and timely manner.
8. Communication & Escalations per guidelines: The Care Management Assistant maintains effective communication within the care management team and escalates any concerns or issues according to established guidelines. They act as a liaison between patients, clinicians, and other healthcare professionals to facilitate effective communication and resolution of any care-related challenges.
Other Information
Other information:
Education Requirements:
• High school diploma or GED required; higher-level degree may satisfy this requirement.
Licensure/Certification Requirements:
• No licensure or certification required.
Professional Experience Requirements:
• Minimum of 2 years of healthcare experience required.
Knowledge/Skills/and Abilities Requirements:
• • Strong organizational skills and the ability to prioritize tasks effectively.
• Excellent communication and interpersonal skills to engage with patients, families, and healthcare professionals.
• Proficiency in using healthcare software systems and electronic medical records.
• Knowledge of care coordination principles, healthcare regulations, and documentation requirements.
• Ability to work collaboratively in a team environment and adapt to changing priorities.
Job Details
Legal Employer: NCHEALTH
Entity: UNC REX Healthcare
Organization Unit: Rex Case Management Services
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $19.98 - $28.54 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Onsite
Work Schedule: Day Job
Location of Job: US:NC:Raleigh
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.