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Case Manager

This job is no longer available

Minneapolis, MN, USA
Full-time

The Cystic Fibrosis Foundation, located in Minneapolis, MN is currently seeking a Case Manager to join the Compass team in the Policy & Advocacy department. 

Areas of Responsibility: 
  • Conduct intake, screening, assessment, coverage and reimbursement/prior authorization/appeal research and triage to appropriate resources for customers who contact CFF Compass. 
  • Enter customer information and track disposition of cases into the database. Position serves as subject-matter expert in area of coverage and reimbursement and requires ability to work on cases independently with minimal supervision.
  • Collaborate with internal and external customers and to properly triage cases to the appropriate groups as needed. 
  • Demonstrate ability to multitask -- working on primary responsibilities while participating in ongoing and ad hoc projects.
  • Perform the above job functions from the local CF Foundation chapter, and report to and coordinate with the National Office Compass staff for daily responsibilities.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Follows department standard operating procedures and internal policies.
  • Exhibits and maintains confidentiality pertaining to patient health information.
  • Reviews & evaluates patient cases with support from lead case manager to educate callers regarding how to determine  insurance benefits for coverage of drug(s) and/ or devices
  • Assists callers with initiating and/or completing prior authorizations or appeals for insurance denials. Provides support documents as needed.  
  • Assesses whether patients qualify for co-pay assistance programs or programs for the uninsured and triages callers to the appropriate program(s) as needed
  • Assesses whether patients qualify for federal/state programs, provides guidance and triages as appropriate.
  • Enters customer information into the database and creates appropriate service requests and designates to the appropriate agent as needed
Educational Background: 
Bachelor’s degree preferred
Skills/Experience: 
  • Two years minimum experience in a healthcare or patient support services environment
  • Knowledge of Medicare coverage and reimbursement  
  • Experience determining Medicaid/SSI/SSDI eligibility
  • Knowledge of third party payers, private (both local and national), federal, and state
  • Experience with co-pay Foundations and patient assistance programs
  • Experience conducting benefit investigations, prior authorizations, and appeals 
  • Basic computer skills necessary, including Internet, Oracle/Microsoft Dynamics CRM, MS Word, Excel, and Microsoft Outlook

Organization Info

Cystic Fibrosis Foundation

Overview
Headquarters: 
Bethesda, MD, United States
Founded: 
1957
About Us
Mission: 

The mission of the Cystic Fibrosis Foundation is to cure cystic fibrosis and to provide all people with the disease the opportunity to lead full, productive lives by funding research and drug development, promoting individualized treatment and ensuring access to high-quality, specialized care.

The Cystic Fibrosis Foundation has 70 chapters and branch offices across the country that work diligently to raise funds to help support the search for a cure. In addition, the Foundation provides funding for and accredits more than 120 CF care centers and 53 affiliate programs nationwide, including more than 100 programs for treating adults with CF. The high quality of specialized care available throughout the care center network has led to the improved length and quality of life for people with CF. Located at teaching and community hospitals across the country, these care centers offer the best care, treatments and support for those with CF.

Listing Stats

Post Date: 
May 30 2019
Active Until: 
Jun 30 2019
Hiring Organization: 
Cystic Fibrosis Foundation
industry: 
Nonprofit