Clinical Case Manager (Remote)

Position Title: Clinical Case Manager
Reports To: Director of Patient Care
FLSA Status: Exempt
Updated: 01/2022
SUMMARY: This position is responsible for working with patients, families, and facilities to access, navigate, and provide counsel insurance requirements for non-emergency transportation. To improve the interface experience of the facilities with Allegiance Mobile Health, and therefore increase brand loyalty among our customers. To help ensure the financial viability of transports. Requires advanced knowledge of the medical care delivery system and extensive experience to support independent assessment and judgment.
ESSENTIAL DUTIES AND RESPONSIBILITIES: (Responsibilities include, but are not limited to)

• Manage all aspects of repetitive non-emergent patient transportation.

• Educate and guide patients, facilities, and families in a knowledgeable and efficient manner.
• Customer relationship management (CRM), managing and analyzing customer interactions and data with the goal of improving business relationships with customers, assisting in customer retention, and driving sales growth.

• Complete patient evaluations on all new repetitive patients.
• Complete evaluations on existing wheelchair patients when the condition necessitates transportation changes.
• Coordinates transportation services with the patient, facility, and insurance company ensuring the patient is transported by the most appropriate means.
• Coordinate appointments to ensure patients arrive in a timely manner.
• Facilitate the process for applying and verifying Prior Authorization for transportation.
• Ensure all necessary paperwork is completed prior to transport. (PCS, PAN, facility contract, and private payment).

• Complete necessary documentation for reimbursement of transport.

• Maintain communication with the patient, family, billing department, communications center, facility, and the insurance company.
• Provide education to include facility PAN classes.
• Educate and explain to the patient and family all requirements for non-emergency ambulance transportation reimbursement.

• Identify specific opportunities to direct marketing efforts toward particular areas.
• Operate as a contact for new clients.
• Track key account metrics.
• Develop and maintain effective working relationships with all key supervisors and managers within the company.
• Assist with the Team development of implementation of marketing and customer service
• Give input on company business development materials and needs.
• Assist with planning, organization, and execution of promotional activities.
• Maintain and build customer relationships with routine follow-up activities.
• Provide customers with data and source information to meet their company objectives.
• Develop and maintain a trusted advisory relationship with customers.
• Identify professional and trade associations with which to affiliate.
• Scheduling networking meetings
• Adhere to all company policies and procedures.
• Accepts other duties as assigned.

KNOWLEDGE AND SKILLS:

• Advanced knowledge of hospital care and transportation clinical practices and procedures.
• Acts calmly and quickly in emergency situations and in matters of substantive importance to the company's clients.
• Ability to analyze and recommend substantive decisions and courses of action.
• Create and maintain a positive and cooperative working environment in stressful situations.
• Excellent time management and multi-tasking skills.
• Proficiency in Microsoft Office suite and products.
• High degree of professionalism working with internal and external customers.
• Strong organizational skills, high attention to detail, and the ability to work independently.
• Strong knowledge of client development and marketing principles in the service industry.
• Demonstrated skills in oral, written, and interpersonal communication.
• Possess and maintain a valid driver's license and be insurable.

PHYSICIAL REQUIREMENTS:

• Work around standard office conditions, repetitive use of a keyboard at a workstation, use of manual dexterity, talking on the phone, and driving a motor vehicle.

MINIMUM QUALIFICATIONS:

• High School diploma or GED preferring two years of college.
• Preferred EMT or Paramedic Certification in the State of Texas.
• One year of private EMS experience.
• Knowledge of Medicare and Medicaid as it applies to non-emergent transports.
• Possess and maintain a valid driver's license and insurable with our carrier.

Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Other duties, responsibilities, and activities may change or be assigned at any time with or without notice.
Allegiance is an EEO employer as defined by the EEOC.