A Care Management Associate typically works in the healthcare setting, assisting the Care Manager in executing and coordinating discharge plans for patients, and to help in providing the needed resources and referrals. While duties vary from setting to setting, the following are certain core duties that are listed on the Care Management Associate Resume – hiring and training of new hires, assisting with the transition of new business; making outreach calls; providing accurate case documentation of all services; identifying triggers; pulling on inpatient admission list; and providing alternative payment information and other details to patients.
The nature of the job demands the following skills and abilities – strong understanding of healthcare; the ability to lead major initiatives across organizations; excellent communication skills; knowledge of third-party billing; familiarity with medical and billing terminologies; and knowledge of CPT and ICD-9 coding. A Medical administration degree is a mandatory requirement.
Objective : Dedicated Care Management Associate with two years of experience in enhancing patient care and navigating complex healthcare systems. Proficient in building strong relationships with patients and their families to ensure optimal outcomes. Committed to continuous improvement and collaboration to support member health and well-being effectively.
Skills : Microsoft Office Suite, Patient Advocacy And Communication, Patient Advocacy, Care Coordination
Description :
Developed and implemented standardized processes for distributing Important Medicare Messages (IMM) prior to patient discharge.
Collaborated effectively with healthcare teams and independently managed high volumes of patient discharges across multiple units.
Communicated IMM letters to patients and representatives, ensuring clarity and obtaining necessary signatures.
Maintained strict adherence to HIPAA regulations by verifying patient identity with two forms of ID.
Utilized various healthcare software and tools including EPIC, Allscripts, and Teletracking for efficient patient management.
Kept abreast of current Medicare policies through ongoing training and educational resources.
Assisted in the development of team workflows to enhance service delivery and patient experience.
Experience
0-2 Years
Level
Entry Level
Education
BSN
Health Management Specialist Resume
Objective : Accomplished Health Management Specialist with over five years of expertise in optimizing patient care and streamlining healthcare operations. Skilled in fostering collaborative relationships with patients and providers to enhance health outcomes. Passionate about implementing innovative strategies that drive efficiency and improve overall health management.
Skills : Health Data Analysis, Patient Engagement Strategies, Health Policy Knowledge, Cultural Competence, Documentation Skills
Description :
Conduct comprehensive assessments to identify patient needs and coordinate appropriate interventions.
Collaborate with multidisciplinary teams to develop personalized care plans for optimal health outcomes.
Utilize advanced healthcare information systems to track patient progress and outcomes effectively.
Monitor and evaluate care delivery processes to ensure compliance with regulatory standards.
Facilitate communication between patients, families, and healthcare providers to enhance care coordination.
Lead initiatives aimed at improving service delivery and patient engagement.
Provide training and mentorship to new staff, fostering a culture of excellence in patient care.
Experience
2-5 Years
Level
Junior
Education
MPH
Care Management Associate Resume
Headline : Experienced Care Management Associate with 7 years in enhancing patient outcomes through effective care coordination and support. Expertise in building collaborative relationships with patients, families, and healthcare providers to facilitate optimal care plans. Dedicated to improving health management processes and ensuring compliance with regulatory standards.
Skills : Case Management, Health Assessments, Organizational Skills, Adaptability, Critical Thinking, Compassionate Care
Description :
Facilitated seamless care transitions by coordinating with healthcare providers and community resources.
Conducted thorough assessments to develop individualized care plans tailored to patient needs.
Monitored patient progress and adjusted care plans as necessary to meet health goals.
Educated patients and families on health management strategies to empower self-care.
Ensured accurate documentation of patient interactions and care plans in compliance with regulatory standards.
Collaborated with multidisciplinary teams to optimize patient care and improve health outcomes.
Analyzed data reports to identify trends and areas for improvement in care management processes.
Experience
5-7 Years
Level
Senior
Education
BSHM
Case Management Assistant Resume
Summary : Dynamic Case Management Assistant with a decade of experience in coordinating patient care and optimizing health outcomes. Adept at fostering collaborative relationships with patients, families, and healthcare providers, ensuring seamless communication and support. Proven ability to implement effective care plans and navigate complex healthcare systems to enhance member well-being.
Coordinated comprehensive care plans with healthcare professionals, ensuring adherence to best practices and guidelines.
Conducted eligibility screenings and managed enrollment processes for diverse healthcare programs.
Acted as a liaison between patients, families, and healthcare providers to facilitate effective communication.
Monitored compliance with regulatory standards and maintained accurate documentation throughout the care process.
Utilized data analytics tools to assess patient outcomes and improve service delivery.
Maintained collaborative relationships with community resources to enhance patient support services.
Provided training and support to staff on case management processes and best practices.
Experience
7-10 Years
Level
Management
Education
B.S. Health Mgmt.
Care Management Associate Resume
Summary : With a decade of experience in care management, I excel at optimizing patient outcomes through strategic care coordination and support. My expertise lies in fostering strong partnerships with patients and healthcare teams, ensuring seamless communication and tailored care plans. I am dedicated to enhancing member wellness and navigating complex healthcare systems to deliver exceptional service.
Skills : Healthcare Data Management, Patient Safety, Health Promotion, Referral Management, Outcome Measurement, Technology Proficiency
Description :
Managed incoming calls from providers and members to facilitate pre-certification and registration for surgical procedures.
Coordinated care with nursing staff, verified eligibility, and delivered exceptional customer service.
Supported the Prior Authorization Manager with state reporting and documentation.
Facilitate patient care coordination across multidisciplinary teams.
Maintained accurate records of member interactions in the corporate database to ensure compliance.
Developed and implemented strategies to enhance communication between members and providers.
Conducted follow-up calls to patients post-discharge to assess needs and provide additional support.
Experience
10+ Years
Level
Executive
Education
BSN
Care Transition Specialist Resume
Objective : Compassionate Care Transition Specialist with two years of experience in facilitating patient transitions across healthcare settings. Skilled in coordinating care plans and connecting patients with essential resources. Driven to enhance patient outcomes through effective communication and collaboration with healthcare teams.
Skills : Patient Coordination, Care Plan Development, Interdisciplinary Collaboration, Empathy And Compassion
Description :
Facilitated comprehensive care coordination by collaborating with medical teams and patients.
Enhanced quality of healthcare services through effective communication and patient engagement.
Provided exceptional customer service by addressing inquiries and concerns promptly.
Utilized multiple systems to efficiently manage patient information and care needs.
Contributed to the development of training materials for new staff to improve onboarding efficiency.
Created presentations for team training to enhance staff knowledge of care protocols.
Contacted patients post-discharge to coordinate ongoing care and resource access.
Experience
0-2 Years
Level
Fresher
Education
B.S. Health Admin.
Care Management Associate Resume
Objective : Accomplished Care Management Associate with over five years of experience in optimizing patient care and enhancing health management processes. Proven ability to develop strong relationships with patients and healthcare teams, ensuring effective care coordination. Committed to driving quality outcomes and implementing solutions that improve member well-being and satisfaction.
Skills : Patient Care Documentation, Networking Skills, Stress Management, Quality Improvement, Analytical Thinking, Health Literacy
Description :
Coordinated follow-up appointments, ensuring timely communication between Case Managers and patients.
Maintained accurate documentation of patient cases in compliance with healthcare regulations.
Safeguarded patient confidentiality while adhering to organizational policies.
Conducted comprehensive research to support effective claims processing.
Managed departmental correspondence, ensuring efficient communication flow.
Reviewed reports to monitor high-dollar accounts related to care management.
Provided administrative support to enhance overall operational efficiency.
Experience
2-5 Years
Level
Consultant
Education
BSHA
Case Management Coordinator Resume
Headline : Strategic Case Management Coordinator with 7 years of experience dedicated to enhancing patient care through effective coordination and resource management. Skilled in developing tailored care plans and fostering collaboration among healthcare teams to drive optimal outcomes. Passionate about improving healthcare delivery and ensuring compliance with industry standards.
Skills : Patient Communication, Care Coordination Systems, Patient-centered Care, Insurance Navigation, Community Resources, Crisis Management
Description :
Reviewed and updated case files for Aetna members, ensuring accurate assessment dates and member information in QNXT, Dynamo, and UAS.
Collaborated with Assessment RNs to schedule environmental assessments for members, addressing personal care needs.
Processed authorizations in QNXT for member services in both MLTC and FIDA, ensuring timely access to care.
Utilized Dynamo and QNXT to verify service authorizations for members across various settings, including community, hospital, and nursing facilities.
Ensured vendor and facility participation through comprehensive checks in QNXT.
Coordinated follow-up appointments for Congestive Heart Failure patients with their Primary Care Providers, enhancing care continuity.
Monitored and documented patient progress, contributing to improved care strategies and outcomes.
Experience
5-7 Years
Level
Junior
Education
B.S. Health Mgmt.
Care Management Associate Resume
Summary : Skilled Care Management Associate with 10 years of extensive experience in optimizing patient care and facilitating seamless healthcare navigation. Proven track record of building effective relationships with patients and providers, ensuring comprehensive care plans and enhancing health outcomes. Committed to driving quality improvement initiatives that support member well-being and satisfaction.
Skills : Microsoft Word, Regulatory Knowledge, Emotional Support, Communication Skills, Decision Making, Problem Solving
Description :
Provided customer service for Aetna Healthcare products, ensuring member needs are met effectively.
Screened members to identify necessary medical services and coordinated referrals to appropriate medical staff.
Support patients in navigating healthcare systems effectively.
Utilized Microsoft Office Suite to maintain detailed records and enhance communication.
Coordinated healthcare service delivery under medical supervision, optimizing patient experiences.
Promoted effective internal and external communication to enhance medical management services.
Developed referral protocols for integrated care management across various specialty programs.
Experience
7-10 Years
Level
Senior
Education
BS Health Mgmt
Care Management Associate Resume
Summary : Proficient Care Management Associate with a decade of experience in enhancing patient care and navigating complex healthcare systems. I excel at fostering strong relationships with patients and providers to achieve optimal health outcomes. Passionate about implementing effective strategies that improve care coordination and ensure compliance with industry standards.
Skills : Patient Data Management, Medical Documentation, Program Development, Community Outreach, Resource Allocation
Description :
Screened Medicaid applications for accuracy and compliance with state guidelines.
Designed and implemented a streamlined process for handling complex Medicaid letters, ensuring adherence to regulations.
Conducted outreach calls to gather clinical information and facilitate patient enrollment.
Mentored a team of five Care Managers, resulting in record high client satisfaction ratings.
Conducted non-medical research to support case management processes and ensure appropriate resource allocation.
Supported care plan implementations, promoting effective utilization of healthcare services.
Collaborated with healthcare teams to enhance communication and streamline patient care delivery.
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