Case Management Associate
About The Position
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Reporting to the Manager of Case Management and working under the direction of the Case Managers (CM) and Social Work (SW) staffs, the Case Management Associate provides support to Case Managers and Clinical Social Workers with routine and regulatory clinical and administrative functions.
Requirements
- Computer proficiency required. Microsoft office applications preferred with ability to learn new software.
- Highly developed communications and interpersonal skills, working with diverse population.
- Work independently, be self-directed and contribute as a member of a team.
- Anticipates challenges and develops and implements strategies for addressing them.
- High level of service delivery. Demonstrate initiative with ability to prioritize work, meet deadlines and adapt to changing situations.
- Attention to detail.
Nice To Haves
- Bachelor's of Social Work from an accredited institution preferred. However, would substitute experience and complimentary of Associate Degree
- A minimum of 1-2 years of clinical and/or community resource experience required
Responsibilities
- Provides administrative support related to the discharge process through faxing, copying, and scanning of information, including but not limited to referral sources, insurers, PCP offices; booking rooms for family-team meetings; assisting patients with securing new PCP's prior to discharge; researching DME providers.
- Supports the process of patient referral to SNF, home care, and outpatient. The referral process includes entering clinical information into the 4NEXT referral system and managing the communications regarding acceptance and bed offer or denial with facilities; referrals to outpatient via SharePoint; and contacting home care agencies via telephone with pre-referral information and to establish a start of care date; initiating the patient care referral paperwork.
- Supports the insurance authorization and continued stay process by making initial contact with the insurance CM to confirm contact information and to establish contacts between the payer and SRH CM; submitting fax and online requests for continued stay authorization and monitors the decision from the payer.
- Researches available community resources at the request of the CM or SW.
- Assists the CM, SW, patient and/or family with applications for community resources, such as PT1, handicap placards, and specialized funds.
- Maintains a database for insurance-based processes, e.g. denials and appeals, Medicaid conversion requests and decisions.
- Contacts patients after discharge to home to complete the "Post Discharge Follow-up Phone Call" process and documents the calls per department protocol.
- Other duties will be assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Hospitals
Number of Employees
5,001-10,000 employees
