| |
|
Individualized Care Management
Paraprofessionals
Job Location: Lafayette, IN
Summary:
The paraprofessional assists nurse care managers in the coordination of uninterrupted, cost-effective health care services.
Reports To:
Team Leader Care Manager or Unit Leader Care Manager
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education, Licensure and Experience:
Two (2) years experience in the medical field. Knowledge of medical terminology beneficial.
Language Skills:
Ability to read and interpret demographic information and basic non-clinical medical information. Ability to speak effectively with clients, patients and health care providers.
Mathematical Skills:
Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to interpret simple graphs.
Reasoning Ability:
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to follow scripted clinical review information. Ability to troubleshoot simple problems.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to walk, sit, stand, talk and hear. The employee is frequently required to use hands and fingers to feel and to reach with hand and arms. The employee is required to spend extended periods of time at a computer in which hands and fingers will be used for computer entry. The employee must occasionally lift and or move up to 10 pounds.
Computer Experience:
Must have prior computer experience and be able to navigate the keyboard well. Knowledge of Window-based systems important to this position.
Essential Duties and Responsibilities
Acts as a patient advocate to enhance the quality of the total health care process and to facilitate delivery of services.
Responsible for reporting to the payor all authorizations and case management savings reports that are prepared by the nurse care managers.
Attends client employee benefit education meetings as required.
Performances scripted clinical review for appropriateness of the referral.
Assists the nurse care manager in the preparation of collecting and submitting medical record information to the Clinical Review Committee when medical necessity determination requires physician determination.
Refers complicated utilization review and referral cases to the appropriate nurse care manager.
Coordinates services & supplies provided by vendors, facilities, and/or community resources to implement, monitor, and evaluate the care plan.
Initiates utilization management procedure and referral cases to specialty physicians for uncomplicated referrals.
Performs patient follow-up with:
- non-complicated, ongoing obstetric status data collection; and
- non-complicated, ongoing post treatment status data collection.
Facilitates in the notification process of patients, providers and administrators.
Assists with support staff responsibilities. Including faxing, filing, managing of daily reports, assist with annual reports, distributing voicemail messages.
Participates in quality improvement program as designed by ICM.
All other duties as essential to the position.
Special Notes:
1. As defined in all corporate policies and procedures referring to confidentiality, all employees of Individualized Care Management, Inc. are responsible for maintaining the confidentiality of all patient-specific and provider-specific information.
2. This position may be filled with a part-time employee at the discretion of the Company. The Company reserves the right to change this status at any time deemed necessary.
3. This is a non-exempt position. You are paid on a semi-monthly basis, based upon the number of hours you work per day. Any time worked over eight (8) hours per day is considered overtime and compensable at 1 1/2 times your base hourly wage.
Compensation/Benefits:
Salary is commensurate with qualifications and experience
Individualized Care Management
|
| |
|
|
