Case Management Resource Specialist - Per Diem

Mass General Brigham•Boston, MA

11d•Onsite

About The Position

The Case Management Resource Specialist (CMRS) works collaboratively with Discharge Planning RN Case Managers, providing direct administrative support to the discharge planning processes and to the department. The person in this position will spend time on the clinical units and have direct interaction with patients and their families, clinical and ancillary hospital staff, and other internal and external customers. The CMRS must have strong communication skills and the ability to converse comfortably with patients and their caregivers, department staff, and unit-based staff. The position requires a high degree of flexibility, independence, and willingness to participate in multiple activities and provide support to all members of the Case Management Department. This role is responsible for assisting patients to arrange transportation to/from the hospital for ongoing medical treatment and/or to locate affordable accommodations and support groups. Works closely with the unit-based case manager to facilitate discharge plans to other psychiatric or medical settings. Other responsibilities may include making referrals to and organizing and disseminating information about a range of other related social resources.

Requirements

High School Diploma or Equivalent required
Related Field of Study preferred
2-3 years preferred related experience
Familiarity with medical terminology.
Familiarity with community services/resources.
Ability to maintain effective working relationships with patients/families.
Knowledge of current community resources.
Strong assessment and crisis intervention.
Strong collaborative skills and a desire to work in a complex, fast-paced environment.
Excellent interpersonal skills.
Excellent collaboration, customer service and advocacy skills.
Excellent written and verbal communication skills.

Nice To Haves

Associate's Degree Related Field of Study preferred

Responsibilities

Researches information on community social resources.
Maintains files of brochures, information packets and applications for all types of community resources.
Collaborates with social work staff and personnel from community agencies to obtain needed information.
Assists in planning/implementing in-service presentations by and about community resources.
Assesses patient/family understanding of available resources.
Educates patients/families about appropriate resources and how to access them.
Works collaboratively with Case Managers to support patients discharge plan and care needs along the continuum.
Support and coordination of referrals to internal and external resources, such as rehabilitation facilities, VNAs, hospice, DME providers, high tech vendors.
Actively manages 4NEXT referrals along the continuum of care, including communication with facilities, agencies, and vendors to promote patient progression to discharge and effective transitions of care.
Researches and secures out of state and in-network VNAs and facilities.
Researches/queries insurers for in-network providers for post-acute needs, such as rehab facilities, DME providers, other contracted vendors.
Communicates with insurance companies to expedite and/or manage delays with authorization for post-acute care and services.
Secures DME and oxygen for post-acute needs; maps insurance and geography to identify appropriate vendors: assesses insurance benefits and coordinates the necessary paperwork with the external vendors and medical team for approval for equipment, such as letters of medical necessity, medical record documentation, and prescriptions.
Arranges for and tracks delivery of equipment prior to or post-discharge.
Works collaboratively with the Case Manager, Brewster Ambulance Services Transportation Coordinator and the VPNE care van ambassador to coordinate the various modes of discharge transportation.
Supports the Capacity Coordination Center Case Manager to facilitate network-affiliate hospital to hospital repatriations and with the unit-based CM for non-affiliate repatriations.
Assesses, via electronic systems, patient’s insurance plans and benefits, such as MassHealth eligibility and Medicare benefits and facilitates coordination with Patient Financial Services.
Prepares, explains to patients, and documents delivery of the Medicare Important Message and Medicare Outpatient Observation Notice.
Initiates and/or completes regulatory and other forms, such as MassHealth Long-Term Care and DMH/DDS PASSR forms and processes the completed forms with the appropriate agencies.
Identify and refer to community services, as indicated.
Accesses and navigates the EMR to obtain essential information and documents CMRS progress notes and Resource Specialist Quick Notes per department standards.
Research community resources and programs available for patients and their caregivers including, but not limited to: Assisted Living Facilities, Legal and financial resources, Private duty and block-nursing agencies, Out of state providers.