Care Management Technician II

Position Summary:

 

Location: ORMC

Schedule: M-F some weekends Onsite.

 

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond.

 

ORLANDO HEALTH - BENEFITS & PERKS:

All Inclusive Benefits (start day one)

• Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.

Forbes Recognizes Orlando Health as a Best-In-State Employer

• Forbes has named Orlando Health as one of America's Best-In-State Employers for 2024. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.

Employee-centric

• Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare

Position Summary
The Care Management Technician II in the Care Management department is responsible for initiating and
obtaining new insurance authorization requests for post-acute services. Works collaboratively with case
management team, hospital care team, community partners, and insurance companies to ensure that patient
care needs are met regarding post-acute care prior authorizations. Obtains and maintains contacts with insurance
companies to streamline barrier removal. Maintains knowledge of payer portal functionality and medical necessity
requirements for post-acute care. Understands payer requirements and how to apply benefits in various
circumstances for post-acute care and is responsible for identifying medical criteria for post-acute care from chart
review and developing an effective clinical packet to justify the level of care needed.

Responsibilities:

Essential Functions
• Maintains reasonably regular, punctual attendance consistent with Orlando health policies, the ADA, FMLA
and other federal, state and local standards.
• Maintains compliance with all Orlando health policies and procedures.
• Develops collaborative relationships with hospitals, physicians, community organizations, team members,
post-acute facilities and other referral sources.
• Verifies insurance coverage and obtains authorization
• Maintains authorization log
• Facilitates peer to peers for escalations for authorizations between facilities.
• Works with IT to refine post-acute authorization processes and polices for the organization
• Documents authorization workflows and best practices
• Monitor and obtain updates for authorization requests initiated by post-acute care facilities
• Assists with other Care Management requests as needed, including, but not limited to, patient assessments,
delivery of regulatory notices and arranging patient transportation.
• Maintains reasonably regular, punctual attendance consistent with Orlando health policies, the ADA, FMLA
and other federal, state, and local standards.
• Maintains compliance with all Orlando health policies and procedures.
• Performs all other duties as assigned

Qualifications:

Education/Training
• High school diploma/GED
• Solid computer skills, including proficiency with Microsoft software. Demonstrated proficiency in
communicating sensitive complex information to persons in a hospital environment. Demonstrates the ability
to work independently and execute their own workload. Critical thinking ability necessary to prioritize
workload to ensure tasks are completed in a timely manner and within established timeframe. Interpersonal
skills necessary to facilitate interpersonal communication with team members, department staff, and external
personnel, interact with patients/families, and perform other activities requiring courtesy and tact.

Licensure/Certification
• None

Experience
• Two years’ experience in post-acute insurance authorization OR associate’s degree in healthcare field with
one year of experience in post-acute referral management OR One year of experience in post-acute
insurance authorization.