Care Management Resource Center Specialist

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

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**Applicants must reside in Northeast Ohio

Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.    

The Care Management Resource Center receives and

appropriately addresses all requests from the TCC/SW to ensure transitions of care are facilitated in a timely manner. As a Center Specialist, your responsibilities often include initiating the post-acute pre-certification process with facilities and insurance companies, making referrals to post-acute agencies and documenting the details of the discharge transition plan. 

This is a remote role after training with on-site requirements occurring once per month. A caregiver in this position works from 9:00am to 5:30pm. 

A caregiver who excels in this role will:  

• Support the Transitional Care Coordinator and Inpatient Social Worker with specified non-clinical work. 
• Initiate contact with payers to facilitate precertification for transfer to post-acute facilities, provide clinical documentation and ensure timely follow up calls. 
• Initiate contact with post-acute agencies, provide updates as requested and facilitate placement. 
• Facilitate 7000 forms by Healthcare Electronic Notification System (HENS). 
• Place and close referrals in AllScripts Care Management. 
• Handle calls from commercial payor case managers with questions regarding admitted patient’s discharge plans. 
• Manage post-acute pre-cert process for commercial insurance patients needing pre-cert to post-acute facilities. 
• Provide necessary verbal and electronic communication to and from care management staff, serving as a liaison between hospital personnel and the various agencies. 
• Serve as a central hub communicator for discharge plan information. 
• Completes data tracking and collection to assist with the identification of routine statistics and problems or trends. 

Minimum qualifications for the ideal future caregiver include:  

• High School Diploma or GED 
• Three to five years of current administrative/clerical experience working in healthcare or a related field 
• Fluency in medical terminology 
• Computer literacy 
• Excellent verbal and written communication and organization skills 

Physical Requirements:

• Ability to perform work in a stationary position for extended periods
• Ability to operate a computer and other office equipment
• Ability to communicate and exchange accurate information

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. 

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster. 

Cleveland Clinic is pleased to be an equal employment opportunity employer.