Care Management Associate Job Description
Care Management Associate Duties & Responsibilities
To write an effective care management associate job description, begin by listing detailed duties, responsibilities and expectations. We have included care management associate job description templates that you can modify and use.
Sample responsibilities for this position include:
Care Management Associate Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Care Management Associate
List any licenses or certifications required by the position: MDS, ANCC, BC, RN, ACM, CCM, GOLD
Education for Care Management Associate
Typically a job would require a certain level of education.
Employers hiring for the care management associate job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Business, Health, Education, Associates, Nursing, Medical, Communication, Science, High School Education, Health Care
Skills for Care Management Associate
Desired skills for care management associate include:
Desired experience for care management associate includes:
Care Management Associate Examples
Care Management Associate Job Description
- Distributing cases to appropriate clinical staff
- Potentially conducting initial outreach calls to members and/or provider offices
- Running and compiling related reports
- Contributing to the triage, solutioning, and management of implementation impediments, usability concerns and defects for existing products
- Investigating, gathering and documenting detailed information regarding bugs, defects and/or enhancements
- Translating project objectives and high level requirements into epics and stories
- Participating in the prioritization of maintenance queue with the Product Owner
- Working on multiple tasks simultaneously with demanding timelines
- Work effectively with Client Executive Leadership, Consulting Advisory Board Company partners
- May redirect or forward requests to the appropriate department by following established guidelines
- Technical services experience
- Professional experience in hospital or heath plan setting
- Willingness to travel up to 25% to other client sites and ABC offices
- Subject Matter Expertise in Care Variation or quality improvement
- Background in health care consulting or technology services
- Experience creating client-ready presentations through the use of advanced PowerPoint techniques
Care Management Associate Job Description
- Perform general administrative duties such as preparing reports as requested, assist other team members as needed, and perform other duties as assigned
- Carries out and coordinates administrative duties as assigned, which may include record retrieval, distribution, documentation and filing, handling logistics for scheduling and coordinating meetings, care manager calls and visits, assisting Supervisor with time and attendance, new hire onboarding and other administrative functions
- Conducts health support calls upon request, appointment confirmations
- Treats guests, patients, physicians and employees with care, courtesy and respect consistent with the UNC HCS Code of Conduct standards
- Responds to customer requests for information, service, and support via telephone, in person, or by electronic means
- Answers incoming calls and handles/directs as appropriate, providing prompt and accurate feedback to callers
- Coordinates scheduling of and support for appointments, meetings, workshops, and team group calendars including travel arrangements, based on identified needs
- Maintains appropriate inventories of supplies for the department and coordinates the orderly distribution and timely reordering of such items
- Prepares complex forms, reports, presentations, and other documents requiring a high level of software proficiency, formatting per established standards
- Maintains records, databases, and files in accordance with established procedures and systems
- 5-10 years of specialty pharmaceutical experience
- 6 years in account and/or 2 years sales management experience
- Must have a high degree of understanding of the Cardiovascular community in general and a working knowledge of Cardiovascular products is preferred
- Must have a strong track record of therapeutic area/product knowledge expertise
- Possesses strong task and project management skills
- 1 year or more customer service experience
Care Management Associate Job Description
- Supports special projects including, but not limited to, personnel space moves, staff on-boarding, and departmental fit testing
- Uses departmental guidelines and job aids to perform work in an accurate, compliant manner consistent with known and written expectations and work rules
- Maintains current knowledge of institutional and departmental expectations for job performance through attendance at meetings, review of meeting minutes and guidance documents, and independent review of institutional and departmental policies and guidelines as needed
- Participates in process improvement initiatives, which may include helping with the creation/revision of guidelines, training tools, and job aids
- May assist with training/precepting as needed and assigned
- Work effectively with Client Executive Leadership, Consulting partners
- Speak to small and large internal and client groups to effectively communicate key messages to disparate groups of audiences to drive the necessary call to action required to affect the strategy
- You'll play an essential role in assisting the nurses in the development of effective and efficient care coordination and self care for our members
- The Care Management Associates will be responsible for making outreach calls to members who are eligible for our programs
- Completes calls / assignments and ensures census management, productivity weekly and monthly standards are met
- Must have a working knowledge of managed care regulations and system dynamics, including inpatient settings and reimbursement
- A minimum of 3 years of Product Owner, Business Analyst or Systems Analyst experience and a Bachelor’s Degree in business/clinical/information technology/related field of study OR 5 years of related experience
- Analyst experience with Clinical Business Process Automation
- For physicians, a M.D/DO or foreign equivalent required
- 1+ years of experience in a medical setting is preferred
- 1-3 years experience in a medical setting is preferred
Care Management Associate Job Description
- Maintain strict confidentiality at all times to include but limited to patients and coworkers
- Comply with all organizational policies regarding ethical business practices
- Documents all patient interactions in a concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations
- Coordinates and assists in monitoring of documentation Care Management queues for Concurrent, Complex Care, and Social Work referrals, CTA processes UM requests via all communication venues
- Performs daily preparation of Inpatient Census to include monitoring of UM expedited, standard, concurrent in-patient cases in “pend” and informs Care Management Manager of outstanding cases to ensure adherence to CMS regulations
- Schedules and coordinates patient transportation, follow-up physician appointments in all applicable markets, as applicable
- Completes timely data entry of in-bound and/or out-bound call member contact information into software applications (Claims Database, TruCare)
- Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs
- Attends required meetings and participates in adhoc committees as needed
- Maintains knowledge of all health plan benefits, network, CMS, regulations, health plan policies
- Medical terminology knowledge or clinical exposure
- Managed care contracting experience
- Adaptable and flexible with the ability to meet timelines
- Proficient in multiple PC based software applications and systems
- Medicare and/or Public Programs experience may be necessary for some positions
- Knowledge of state and/or federal regulatory policies and/or provider agreements, and a variety of health plan products
Care Management Associate Job Description
- Carries out and coordinates administrative duties as assigned, which may include assigning
- Gather and organize client experience data – in support of Client Experience reporting development
- Ensure change request requirements and design are well documented
- Coordinate with program participants to outline their prioritization of requests
- Conduct testing and provide change implementation support
- You'll play an essential role in assisting the nurses/coaches in the development of effective and efficient care coordination and self care for our members
- Strong teamwork skills -Must possess strong computer and keyboarding skills
- Consumer Academy
- Voices Closed Loop Optimization
- Voices Ask Now (ad-hoc client experience surveys)
- Computer literacy in order to navigate through internal/external computer system
- 1 year Healthcare experience, may include Healthcare student experience, Minimum required
- Excellent interpersonal and organization skills, Minimum required
- Ability to work with and preserve confidential information, Minimum required
- Ability to deal effectively with diverse groups of people, Minimum required
- Ability to work independently and in a self directed manner, Minimum required