Case Management Associate

Mass General Brigham•Cambridge, MA

21h•Onsite

About The Position

The Case Management Associate provides support to case managers and clinical social workers with routine and regulatory clinical and administrative functions. The position supports patient referrals, insurance authorization and continued-stay processes, and access to community resources. This is an onsite role at 1575 Cambridge Street, scheduled for 40 hours per week on the day shift. Patient care is required.

Requirements

Associate's degree in Social Work required, or a Bachelor's degree in Social Work preferred; experience may be accepted in lieu of a degree.
Attention to detail.
Computer proficiency; Microsoft Office applications preferred, with the ability to learn new software.
Highly developed communication and interpersonal skills for working with varied populations.
Ability to work independently, be self-directed, and contribute as a team member.
Ability to anticipate challenges and develop and implement strategies to address them.
High level of service delivery.
Initiative and ability to prioritize work, meet deadlines, and adapt to changing situations.

Nice To Haves

One to two years of clinical and/or community resource experience preferred.
Bachelor's degree in Social Work preferred.

Responsibilities

Support referrals to skilled nursing facilities, home care, and outpatient services by entering clinical information into referral systems and coordinating communications about acceptance, bed offers, or denials.
Submit outpatient referrals through SharePoint and contact home care agencies by telephone with pre-referral information and to establish start-of-care dates.
Initiate patient care referral paperwork.
Support insurance authorization and continued-stay processes by contacting insurance case managers to confirm contact information and establish communication between the payer and the SRH case manager.
Submit fax and online requests for continued-stay authorization and monitor payer decisions.
Research community resources at the request of a case manager or social worker.
Assist case managers, social workers, patients, and/or families with applications for community resources.
Maintain a database for insurance-based processes, including denials and appeals, and Medicaid conversion requests and decisions.