Integrated Care Management Assistant Utilization Management

Qualifications:

Required

·         Associate degree in healthcare-related field

·         Two years of clerical experience

·         One-year experience in a heath care environment utilizing medical terminology or have completed a college level course in medical terminology

·         Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN)

Preferred: 

• Bachelor’s degree in coding/medical records/billing or healthcare related field
• Two years of case management or utilization review, billing, or coding experience

·         Three years of recent experience doing third party payer certification

Knowledge, Skills, and Abilities:

·      Ability to handle multiple tasks and complete work within short timeframes.

·      Ability to understand, interpret, explain, and use data for case management activities.

·      Ability to work with diverse teams and individuals, team player.

·      Able to spend majority of time utilizing a computer, monitor, keyboard and mouse; ability to type.

·      Competency in applying the principles, methods, materials, and equipment necessary in 
providing utilization management services.

·      Demonstrated expertise in utilization management principles, methods, and tools and incorporating them into the daily operations of the organization.

·      Excellent time management and organization skills.

·      Knowledge of care delivery systems across the continuum of care including, but not limited to, trends and issues in care reimbursement, medical necessity and assigning level of care assignment (inpt vs obs).

·      Must be able to act calmly and effectively in busy/stressful environment.

·      Must be able to work independently, and utilize problem solving techniques and critical thinking skills.

·     Proficient with Microsoft Office (i.e., Word, Excel, Outlook, and Power Point).

·     Strong verbal and written communication skills: ability to interact productively with leaders, peers, and customers.

·      Must be able to travel to subsidiaries or corporate meetings as needed.

·      Weekend, holiday, and evening coverage as per site requirements.

Position/Subsidiary Specific:

·         Supports the mission and vision of McLaren Port Huron through behaviors that reflect and integrate our values, as evidenced by observation, peer and customer feedback.

Physical Requirements: (X)

Additional requirements detail available upon request

                _              Sedentary Work:  Lifting 10 pounds maximum with frequent lifting and/or carrying such

                                articles as dockets, ledgers, and small tools.  Although sedentary job is defined as one which

                             involves sitting, a certain amount of walking and standing is often necessary in carrying out

                             job duties.  Jobs are sedentary if walking and standing are required only occasionally and

                             other sedentary criteria are met.

            _x_         Light Work:  Lifting 20 pounds maximum with frequent lifting and/or carrying of objects

                             weighing up to 10 pounds.  Even though the weight lifted may be only negligible

                             amount, a job is in this category when it requires walking or standing to a significant

                             degree, or when it involves sitting most of the time with a degree of pushing and pulling

                             of arm and/or leg controls.

__           Medium Work:  Lifting 50 pounds maximum with frequent lifting and/or carrying of

               objects weighing 25 pounds or more. 

__           Heavy Work:  Lifting 100 pounds maximum with frequent lifting and/or carrying of

               objects weighing up to 50 pounds.

__           Very Heavy Work:  Lifting objects in excess of 100 pounds with frequent lifting and/or

               carrying of objects weighing 50 pounds or more.

                X-Ref:  D.O.T. – U.S. Department of Labor – Employment and Training Administration