Job Description

Role Overview:

The Case Manager/Social Services Assistant will play a crucial role in supporting the needs of our patients and residents by assisting with MediCal and Medicare-related tasks, including handling changes to health plans, tier levels, and authorizations. The ideal candidate will have hands-on experience with MediCal, Medicare, and SNF environments and be comfortable working closely with patients, families, and healthcare professionals.

This hybrid role allows flexibility, with 2-3 days in the field (visiting Assisted Living and SNF locations) and 2-3 days of remote work. Travel within the Greater LA/Long Beach area, and occasionally to San Bernardino or Riverside, will be required.

Key Responsibilities:

· Assist with contacting SSI for patients and residents and ensure timely follow-up on changes to tier levels and health plans.

· Help coordinate MediCal authorizations and follow-up with necessary entities to ensure approval.

· Collaborate with healthcare providers, insurance companies, and patients' families to ensure smooth transitions between different health plans.

· Assist in the application process for health plans and benefits, ensuring compliance with all relevant regulations.

· Maintain detailed records of interactions with patients, families, and service providers.

· Ensure timely communication and follow-up regarding all case management activities.

· Provide information and support to patients and their families regarding available healthcare resources, programs, and benefits.

· Travel to Assisted Living and SNF locations for on-site visits as needed.

· Collaborate with internal teams to manage patient and resident cases effectively.

Required Skills and Qualifications:

· A minimum of 2-3 years of experience in a social services, case management, or healthcare-related role, particularly with MediCal and Medicare.

· Strong understanding of MediCal, Medicare, and health plan systems is required.

· Experience working in a Skilled Nursing Facility (SNF) or Assisted Living setting is preferred.

· Excellent communication and interpersonal skills, with the ability to work effectively with patients, families, and healthcare professionals.

· Ability to manage multiple cases and follow up on ongoing healthcare issues.

· Proficiency with basic office software and electronic health record (EHR) systems.

· Ability to work independently and be a proactive problem-solver.

Preferred Skills and Qualifications:

· Bachelor’s degree in Social Services, Healthcare Administration, or a related field.

· Experience with Assisted Living Waiver (ALW) programs or CALAim initiatives.

· Knowledge of healthcare regulations and policies related to SNF and Assisted Living settings.

· Strong organizational skills and attention to detail.

Candidate Profile:

· Compassionate, empathetic, and committed to improving the quality of life for patients and their families.

· Able to handle sensitive information with professionalism and confidentiality.

· Highly motivated with a flexible approach to changing tasks and environments.

· Comfortable with travel and working in both field and office settings.

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