About this Case Management Associate role at Mass General Brigham
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
SummaryProvides support to case managers and clinical social workers with routine and regulatory clinical and administrative functions.
Does this position require Patient Care?
Yes
Essential Functions
-Supports the process of patient referral to SNF, home care, and outpatient. The referral process includes entering clinical information into the 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,
-Maintains a database for insurance-based processes, e.g. denials and appeals, Medicaid conversion requests and decisions.
Qualifications
Education
Associate's Degree Social Work required or Bachelor's Degree Social Work preferred
Can this role accept experience in lieu of a degree?
Yes
Experience
Clinical and/or Community Resource experience 1-2 years preferred
Knowledge, Skills and Abilities
- Attention to detail.
- Computer proficiency required Microsoft office applications preferred with ability to learn new software.
- Highly developed communications and interpersonal skills, working with varied 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.
Additional Job Details (if applicable)
Physical Requirements
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$22.35 - /
Grade
3
EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.