Care Management Specialist

Care Management Specialist

As Mount Sinai grows, so does our legacy in high-quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Position Responsibilities:

• Identifies all patients needing a MOON or an initial IMM based on patient's insurance coverage and admission status using the Epic work queues.
• Explains the notices and answers questions to ensure patients understand their rights and responsibilities. Explains the right to appeal the discharge when appropriate.
• Captures the patient's or patient representative's signature on all notices as necessary (including MOON, IMMs, Detailed Notices, Choice Letters, HINN).
• Provides a follow up IMM and Choice Letter to patient or patient representative as requested by the care manager or social worker.
• Collects, copies, and transmits pertinent clinical and patient demographic information to the QIO when patients requests a discharge appeal.
• Upon completion of the discharge appeal, provides a HINN 12 if needed to notify patient of QIO's decision.
• Maintains regular communication with Social Workers, Care Managers, and Care Management Leadership.
• Documents all patient and family interactions according to department policy.
• Maintains positive interpersonal relationships and maintains a professional image by adhering to customer service standards in dealings with internal and external contacts, whether in person, by phone, or electronically; communicates to involved parties as appropriate on assigned duties and actions.
• Demonstrates sufficient computer skills to perform job function. Checks voicemail and email as instructed by leadership and as warranted.
• Participates in weekend rotation as required.
• Willing and able to cover other areas in the department if needs arise.

Qualifications:

• High School Diploma or GED
• 2 years health care experience preferred. Knowledge of care management functions.

Benefits:

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs. Our robust employee benefits package includes:

• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Pet Insurance
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site housing for selected positions and more!