Care Management Associate

Support comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of reputed company services. Promotes/supports reputed company effectiveness of reputed company Services. Responsible for initial review and triage of Care Team tasks. Identifies reputed company reason for admission, facility, and member product to correctly apply reputed company assessment tools. Screens patients using targeted reputed company business rules and processes to identify needed medical services, reputed company appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. Monitors non-targeted cases for entry of appropriate discharge date and disposition. Identifies and refers reputed company cases (e.g., Length of Stay) to clinical staff. Identifies triggers for referral into reputed company's Case Management, Disease Management, Mixed Services, and other Specialty Programs Utilizes eTUMS and other reputed company systems to build, research and reputed company member information, as needed. Support the Development and Implementation of Care Plans. Coordinates and arranges for reputed company delivery under the direction of reputed company or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,health care providers, and health care team members respectively) Performs non-medical research pertinent to the establishment, maintenance and closure of reputed company cases. Apply tot his job Apply To this Job