Case Management Associate

Spaulding Hospital - Boston and Cambridge; Cambridge (MA); On-site; USD 31,000 - 37,000; Full time

Job summary

Spaulding Hospital - Boston and Cambridge is seeking an Administrative Support role to assist case managers and social workers with routine clinical and regulatory tasks. This position includes patient referrals, insurance coordination, and community resource research.

Requires an Associate's or Bachelor's in Social Work and 1-2 years of relevant experience, plus strong communication and detail orientation. Onsite in Cambridge with a 40-hour work week; team-oriented and independent work possible.

Qualifications

• Associate's Degree in Social Work or Bachelor's Degree in Social Work.
• 1-2 years of Clinical and/or Community Resource experience preferred.
• Strong communication and interpersonal skills; detail orientation.

Responsibilities

• Assist case managers and social workers with referrals and documentation.
• Support insurance authorization and continued stay processes with payers.
• Research community resources as requested by the CM or SW.
• Assist patients and families with applications for community resources.
• Maintain a database for insurance-based processes including denials and appeals.

Skills

Attention to detail

Communication skills

Teamwork

Independent worker

Prioritization

Education

Social Work degree

Tools

Microsoft Office

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 and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

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

3At 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 accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

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.