Become part of the Beebe team - an inclusive team positioned in a vibrant, coastal community.  Enjoy a fulfilling career as you support the health of our patients and a team focused on excellence.

In addition to competitive compensation and wellness benefits (medical, dental, vision, and prescription) Beebe Healthcare also offers:

• Sign-on and Referral Bonuses for select positions
• Tuition Assistance up to $5,000
• Paid Time Off
• Long Term Sick accrual
• Employer Contribution Plan
• Free Short and Long-Term Disability for Full Time employees
• Zero copay for drugs on prescription plan for certain conditions
• College Bound 529 Savings Plan
• Life Insurance
• Beebe Pers via WorkAdvantage
• Employee Assistance Program
• Pet Insurance

The main function of the Case Management Specialist is to provide non-clinical support for the Case Management team. The Case Management Specialist inputs tracks and trends data, interacts with external managed care organizations, physicians, and billing and case management department staff. The position is also responsible for coordinating audits for regulatory agencies and preparing reports for the UR Committee. The CM Specialist will be responsible for identifying issues and recommending process improvement strategies to optimize reimbursement.

• Supports both the UR and Discharge planning teams in order to implement more efficient centralized work processes. Rounding with DCP's regarding patients leaving for home and need for referrals in the Unite Us platform to link/refer patients to community resources (single point of contact for platform).  This will involve meeting with patient and completing standardized platform tools.  Completion of Patient New Start Dialysis Set up: This involves downloading standard medical information needed for application and forwarding to dialysis provider, scheduling first treatment, interfacing with onsite Davita rep to troubleshoot issues, maintaining communication with assigned discharge planner as to status and any barriers.  Maintenance of communication with outside dialysis facility as to patient d/c and anticipated OP start.  Assist with application for DART transport as needed. 
• Enters, tracks, monitors and reports on denial and appeals as well as completing Medicare One Midnight billing holds to finance. IMM’s: Important Message from Medicare. Completion of Choice Forms for Home Health, and place referrals for same in Navihealth System, monitoring status. Livanta Appeals- download required medical record documentation and send via portal for patient (Medicare) appeals.
• Acts as a data analyst for the department and interfaces with IT to report on utilization and discharge planning metrics. 4) Supports Discharge planning staff by obtaining DME and Skilled Nursing authorizations and other related duties as assigned. Management of stock for DME closet, including paperwork, need for refresh/additional equipment, troubleshooting of issues with provider. Assist DCP with obtaining real time updates on bed availability in local SNF's, acute rehab and other post -acute facilities.
• Supports long stay rounds, surge plans and prepares outlier reports for UR Committee. Assists in preparing committee reports with trends and recommendations for UR and revenue cycle meetings. Using Audit tool, review Discharge Planning documentation and requirements; prepare report with findings to Director.
• Effectively extracts pertinent information from managed care organization (MCO) logs and medical records and assists with preparing appeals in a concise, coherent and efficient manner. 
• Submits UR continued stay documents to managed care organization under the direction of department lead. 
• Arranges for peer-to-peer reviews with managed care physician and / or physician advisor or attending. Submits results of Physician Advisor determinations in systems. Liaison b/w BB Infectious Disease and OP Infusion for insurance authorization (specialty med inpatients only, & needed for d/c), using standardized process. 
• Contacts Managed Care Organization to obtain authorizations for admissions and continued stay when not accounted for. Coordinates concurrent appeal process by identifying cases, collaborating with physician advisors, utilization review staff and MCO's to quickly overturn inappropriate denials by the MCO.
• Performs other related duties as assigned.

• Two (2) to five (5) years’ experience in health related field.
• Five (5) years of administrative support preferred in a hospital setting.  
• Knowledge of Microsoft Word, Excel, and Power Point required.
• Experience with report writing and data analysis required.
• Experience with developing and maintaining databases and working with various software applications required

• AA Degree required.

About Beebe Healthcare

Beebe Healthcare serves the Sussex County community with a medical center located in beautiful, historic Lewes, Delaware, and convenient outpatient locations throughout the county. Founded in 1916 by two physician brothers, Drs. James Beebe and Richard C. Beebe, the medical center in Lewes is a 210-licensed-bed, not-for-profit seaside community hospital. Beebe's specialized service lines include cardiac and vascular, surgical services, oncology, women's health, and orthopaedic services. Beebe offers an array of inpatient, outpatient, emergency, and diagnostic services. Beebe's five satellite campuses offer imaging, physical rehabilitation, and lab services, as well as walk-in care centers. In addition, Beebe offers Wound Healing & Hyperbaric Medicine and Diabetes Management & Medical Nutrition Therapy. With a mission to serve the community, Beebe also offers many free screenings and outreach programs through its Population Health Department; and advanced medical care for those who are recuperating at home through Beebe Home Care Services. Beebe is also training the next generation of nurses through the Margaret H. Rollins School of Nursing, located behind the Medical Cente...r in Lewes. Beebe's Medical Staff has grown tremendously since the early 1990s. Employed physicians through Beebe Medical Group and our affiliated physicians on Beebe's Medical Staff now serve patients from Milford to Millville in specialties including cardiac surgery, dermatology, endocrinology, family practice, gastroenterology, general surgery, internal medicine, pediatric neurology, and surgical oncology. Beebe is proud to offer quality care, close to home for the residents and visitors of Sussex County.

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Connections working at Beebe Healthcare