Case Management Associate

The General Hospital Corporation; Cambridge (MA); On-site; USD 31,000 - 37,000; Full time

Job summary

Spaulding Hospital Cambridge, Inc. is seeking a supportive roles assistant to backstop case managers and clinical social workers in clinical and administrative tasks. You will assist with referrals, authorizations, and community resource navigation to improve patient care pathways.

The role requires an associate or bachelor’s degree in social work and 1–2 years of related experience, with strong communication and computer skills. Onsite location at 1575 Cambridge Street.

Qualifications

• Associate's Degree Social Work required or Bachelor's Degree Social Work preferred.
• Clinical and/or Community Resource experience 1-2 years preferred.
• Proficient in Microsoft Office with ability to learn new software.
• Strong written and verbal communication for diverse populations.
• Ability to work independently and as part of a team.

Responsibilities

• Supports the process of patient referral to SNF, home care, and outpatient, including entering clinical data and coordinating bed offers.
• Supports insurance authorization and continued stay processes by contacting the CM and submitting requests.
• Researches available community resources and assists with applications for those resources.
• Maintains a database for insurance-based processes such as denials and appeals.

Skills

Attention to detail

Computer proficiency

Interpersonal skills

Teamwork

Prioritization

Communication

Education

Associate's Degree in Social Work

Bachelor's Degree in Social Work

Job description

Site: The Spaulding Rehabilitation Hospital Corporation

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.

Job Summary

Provides 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

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

• Standing Frequently (34-66%)
• Walking Frequently (34-66%)
• Sitting Occasionally (3-33%)
• Lifting Frequently (34-66%) 35lbs+ (w/assisted device)
• Carrying Frequently (34-66%) 20lbs - 35lbs
• Pushing Occasionally (3-33%)
• Pulling Occasionally (3-33%)
• Climbing Rarely (Less than 2%)
• Balancing Frequently (34-66%)
• Stooping Occasionally (3-33%)
• Kneeling Occasionally (3-33%)
• Crouching Occasionally (3-33%)
• Crawling Rarely (Less than 2%)
• Reaching Frequently (34-66%)
• Gross Manipulation (Handling) Frequently (34-66%)
• Fine Manipulation (Fingering) Frequently (34-66%)
• Feeling Constantly (67-100%)
• Foot Use Rarely (Less than 2%)
• Vision - Far Constantly (67-100%)
• Vision - Near Constantly (67-100%)
• Talking Constantly (67-100%)
• Hearing Constantly (67-100%)

Remote Type

Onsite

Work Location

1575 Cambridge Street

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$22.35 - $26.58/Hourly

Grade

3

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

EEO Statement:
1460 Spaulding Hospital-Cambridge, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable acc