Care Management Support Specialist

TuftsMedicine; United States; Remote; USD 42,000 - 68,000; Full time

Job summary

Tufts Medicine Integrated Network is seeking a Care Management Referrals Specialist to triage and route patient referrals within the EPIC Compass Rose system. You will collaborate with ambulatory practices, health plans and hospitals to ensure timely, coordinated care across the continuum.

This remote role requires local presence for occasional travel to Massachusetts locations and offers 40 hours weekly, with standard M-F hours. Strong EPIC experience and clinical background preferred.

Qualifications

• High School Diploma or equivalent.
• Two years of clinical setting experience.
• Experience in Nursing Unit, Care Management, Managed Care setting, PCP or SCP office setting.

Responsibilities

• Triage referrals to the Ambulatory Care Management Department within the EPIC Compass Rose platform.
• Ensure referral work queues are up to date and meet established turnaround times.
• Complete required documentation in EPIC and other department databases.
• Serve as the care management referrals subject matter expert for team members and other collaterals.
• Act as primary contact for internal and external collaterals such as health plans and hospitals.
• Develop professional relationships with internal and external partners to support department goals.
• Run and reconcile regular care management reports including discharge and admission data.
• Analyze team performance, referral volume, and program trends to inform management.

Skills

Customer-focused communication

Autonomy

Team collaboration

Education

College degree

Medical Assistant Certification

Tools

EPIC Compass Rose

EMR systems

Job description

Hours: 40 hours per week; M-F 8:00-4:30 PM Location: Remote, candidate must be local as occasional travel may be required to our locations in Massachusetts as needed.

About Tufts Medicine Integrated Network

The Tufts Medicine Integrated Network is a distinctively different population health enterprise, including 3,500 physicians and advanced practice clinicians. Working as Tufts Medicine employees or in private practice, we deliver exceptional, coordinated care in both community and hospital settings, with a sharp focus on value-based care and health equity. Our purpose is to build healthier communities and create healthy, rewarding experiences for our patients and care teams.

Job Overview

This position works closely with the ambulatory network, health plans, community partners and the care management team to triage referrals and assign them to care teams to ensure that patients receive comprehensive and coordinated care through the continuum of care. This position is an integral member of the Care Management Department, who directs patient referrals to the appropriate care and resources. Collects patient information and assessments to determine patients' primary needs, to connect patients to the correct care team. Develops close relationships with and serves as one of the primary contacts for the various collaterals who utilize the department's services and supports. Takes the lead on various reporting requirements for the department. This will involve proficiency in running and manipulating reports and data within the system's EMR.

Minimum Qualifications

• High School Diploma or equivalent.
• Two (2) years of clinical setting experience. This may include experience in a Nursing Unit, Care Management Department, Managed Care setting, PCP or SCP office setting.

Preferred Qualifications

• College degree OR Medical Assistant National Certification Attestation issued by a governing body (AAMA, AMCA, AMT, NCCT, or NHA).
• Four (2) years of clinical setting experience. This may include experience in a Nursing Unit, Care Management Department, Managed Care setting, PCP or SCP office setting.
• Experience working in the human services field.

Duties and Responsibilities

• Works within the EPIC Compass Rose platform to triage referrals to the Ambulatory Care Management Department.
• Ensures referral work queues are up to date; adhering to the established timeframes for referral assignment turnaround.
• Completes required documentation in EPIC, as well as other department-sponsored databases in a timely and accurate manner.
• Operates as the care management referrals 'subject matter expert'; being a resource to team members, ambulatory practice and hospital staff, and other collaterals who refer into the department.
• Acts as the primary contact for internal and external collaterals, such as health plans, ambulatory practices, hospitals, and Community Partners.
• Develops trusting and professional relationships with our internal and external collaterals; engaging respectfully and with the utmost attention to service.
• Responds promptly to requests made to the department and leverages team members when appropriate.
• Runs and reconciles regularly scheduled reports for the care management team, including hospital discharge and admission data.
• Runs regularly scheduled reports for management to review and analyzes team performance, referral volume, and overall program trends.
• Collaborates with management to ensure workflows are adequately meeting the needs of the department and the patient population we serve.
• Trains staff, as needed, on systems for coverage as well as onboarding purposes.
• Maintains collaborative relationships with peers and colleagues in order to effectively contribute to the organization's achievement of goals.
• Helps foster a positive work environment including working collaboratively with internal staff and all affiliated organizations.

Physical Requirements

• Frequent sitting, occasional standing or working, and lifting of 10-15 lbs.
• May be exposed to dust and other typical office-like discomforts.
• Manual dexterity using fine hand manipulations for computer keyboard operation.
• Requires ability to see computer screen and read reports.
• Requires ability to hear instructions from physicians and other clinical or nursing staff.

Skills & Abilities

• Demonstrates customer focused interpersonal skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, patients, and families with diverse opinions, values, and religious and cultural ideals.
• Demonstrates ability to work autonomously in established situations and be accountable to the goals of the department.
• Demonstrates a