Case Management Assistant- Transitional Care Services- Bakersfield

Description

Location:

Bakersfield, CA. (Onsite)

Classification:
Full-Time

This position is non‑exempt and will be paid on an hourly basis.

Monday‑Friday 8am-5pm

• Medical
• Dental
• Vision
• Paid Time Off (PTO)
• Floating Holiday
• Simple IRA Plan with a 3% Employer Contribution
• Employer Paid Life Insurance
• Employee Assistance Program

The initial pay range upon commencement is $21.31‑26.63 per hour, subject to adjustments based on relevant knowledge, skills and experience. We offer competitive packages to attract top talent.

The Case Management Assistant—Transitional Care Services (TCS) supports the Case Management Department, including Nurse Case Managers and the Social Services team, coordinating services within the Enhanced Care Management (ECM) Program for transitional care. The role involves managing members transitioning from care settings such as ER visits, acute care, post‑acute care, incarcerations, and other ECM‑recognized settings. Responsibilities include enhanced care coordination, monitoring members, reporting findings, gathering clinical information from external sources, building rapport, coordinating referrals, and collaborating with interdisciplinary teams to define member priorities.

• Collaborates with Clinical or Social Services Case Managers to manage members requiring Transitional Care Services.
• Collects clinical information and coordinates post‑discharge services, including scheduling appointments, ensuring referrals are received, arranging transportation, and ensuring members are aware of follow‑care needs.
• Initiates care transition coordination with referral sources and internal partners, facilitating order transfers via phone, fax, and e‑prescribing, and participates in data collection for therapy start and patient tracking.
• Effectively manages low acuity member cases within the ECM Program.
• Contacts members at regular intervals per acuity level and care plan needs.
• Completes member questionnaires or assessments and documents care management activities in the CM System per protocol.
• Assists Case Managers with care coordination, follow‑up, communication with agencies, and document/report preparation.
• Reports variances and issues to nursing or social services staff assigned to the member.
• Provides appointment scheduling, transportation, referral coordination and other enhanced care services.
• Gathers clinical info from external sources such as PCPs, specialists, EHRs and partner entities.
• Verifies member eligibility, demographics, benefits, primary care physician and specialist authorizations.
• Maintains data integrity by entering information into department systems.
• Performs general office duties, answers phones, provides customer service to ECM members and partnering agencies.
• Collects relevant information during assessments, care planning, team meetings and transitions of care.
• Outreaches to verify needs are met and services delivered.
• Intervenes at the member level to coordinate direct services to members and families.
• Serves as resource to members, providers, staff and external customers regarding policies, benefits and care coordination.
• Assists with system letters, requests for information, and data entry.
• Participates in Interdisciplinary Care Team (ICT) meetings, presenting information and communicating member needs and preferences.
• Attends mandatory departmental and staff meetings.
• Assists with training and orientation of new staff.
• Might conduct in‑person meetings with members during clinic visits.
• Performs other duties as assigned.

• High School diploma or GED required.
• Minimum of 3 years experience in health care or community health setting.
• Advanced knowledge of prior authorization or case management regulations for Medi‑Cal, Commercial, Medicare, CCS, and other programs.
• Experience in a managed health care environment preferred (IPA, HMO, or Health Plan).
• Medical Assistant or Community Health Worker certification preferred.

• Respectful customer service and ability to serve members, support givers, and team members.
• Team collaboration and ability to remove barriers to member health.
• Sensitivity to members'…