Under the direction of the Clinical Resource Management (CRM) team member (RN, SW), responsible for making referrals to post-acute care providers and suppliers of durable medical equipment. Coordinate with transportation partners to supply transport from the acute care setting as identified by the CRM team managing the case. May be tasked to review and provide information on preferred or contracted providers and may provide defined clinical review information by electronic methods or fax. Additional tasks may be required as directed by the CRM leadership team (i.e., providing patients with the Important Message from Medicare).
Maintains ongoing education and knowledge of community resources as identified by the CRM RN and provides input into department resource updates for all staff. Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer skills (i.e., MS Windows, Excel, Access, Word, PowerPoint, internet, email).
Windows computer skills, including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop-down menus, scroll bars, opening folders, copying, and similar operations required upon employment or within the first two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws, and standards. Carries out the mission, vision, and quality commitment of Palomar Health.
Job Requirements
- Minimum Education: High school diploma and/or equivalent combination of education and experience
- Preferred Education: Not Applicable
- Minimum Experience: 1+ years Case Management or Utilization Review
- Preferred Experience: Not Applicable
- Required Certification: American Heart Association recognized BLS - Healthcare Provider within 3 months of hire
- Preferred Certification: Not Applicable
- Required License: Not Applicable
- Preferred License: Not Applicable
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