Case Management Assistant- Fresno

Employment Details

Location: Fresno, CA

Schedule: Monday-Friday 8am-5pm

Classification: Full-Time

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

• Medical
• Dental
• Vision
• Simple IRA Plan
• Employer Paid Life Insurance
• Employee Assistance Program

The initial pay range for this position upon commencement of employment is projected to fall between $19.34 and $24.17. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

The Case Management Assistant provides support for the Case Management Department, including the Nurse Case Managers and Social Services team specifically through the coordination of services within the Enhanced Care Management (ECM) Program.

The Case Management Assistant will provide support by managing low acuity cases, assisting in enhanced care coordination activities, monitoring members, reporting findings, and gathering clinical information from outside sources.

The ECM Program addresses the clinical and non-clinical needs of members with the most complex medical and social needs through systematic coordination of services and comprehensive care management.

ECM is intended to service those with chronic health conditions, are homeless or at-risk, with high hospital admissions, substance abuse, and/or behavioral health needs. This position requires strong interpersonal and organizational skills to build rapport with members, coordinate referrals, and care amongst various healthcare providers and community services.

The Case Management Assistant also works with the member’s inter-disciplinary team (ICT) supporting the member, while engaging the member and their support systems to define priorities that are central to the member’s desired needs and goals.

• Effectively manage low acuity member cases within the ECM Program.
• Contacts members at regular intervals per their acuity level and care plan needs.
• Completes member questionnaires or assessments, and consistently document care management activities and encounters in the CM System, per program protocol.
• Works collaboratively and assists clinical and social services Case Managers with care coordination, member follow-up, communication with appropriate agencies and preparation and distribution of documents and/or reports.
• Works collaboratively and assists the Clinical or Social Services Case Managers to manage members in need of Transitional Care Services (TCS).
• Gather clinical information and assists with coordinating post-discharge services, including scheduling provider appointments, ensuring post-discharge referrals are received by the member, transportation to appointments is arranged, and members are aware of follow-care needs.
• Proactively initiates care transition coordination with referral sources and internal partners to ensure seamless patient transitions to home or ATS. Participates with any data collection required for therapy start and patient tracking process. This may include facilitating the transfer of orders via phone, fax, and e-prescribing.
• Reports variances and issues to nursing or social services staff assigned to the member.
• Assists members with appointment scheduling, transportation, referral coordination, and other enhanced care coordination services.
• Responsible for gathering clinical information from outside sources such as PCPs, specialists and other providers, electronic health records, and other partnering entities.
• Verifies member eligibility, demographic information, and benefits.
• Verifies member's Primary Care Physician and the Physician Specialist to ensure that authorization is requested and issued to appropriate network provider.
• Assists in maintaining the integrity of the data systems by entering information into department’s data systems.
• Provides general office administration duties including answering phones.
• Provides…