Case Management Associate

Salem Hospital; Salem (MA); On-site; USD 30,000 - 34,000; Full time

Job summary

Mass General Brigham is seeking a dedicated professional to support case managers and clinical social workers. The role involves coordinating patient referrals to SNF, home care, and outpatient services, and managing communications with facilities to offer bed acceptance or denial.

You will assist with insurance authorization processes, contact payers, and help establish connections between payers and care managers.

Qualifications

• Associate's Degree in Social Work required or Bachelor's Degree in Social Work preferred.
• Experience in clinical or community resource settings 1–2 years preferred.
• Strong computer skills, Microsoft Office, ability to learn new software.

Responsibilities

• Supports the process of patient referral to SNF, home care, and outpatient, including entering information and coordinating bed offers or denials.
• Supports insurance authorization and continued stay processes by contacting the insurance CM and submitting requests.
• Researches community resources upon request of CM or SW and assists with applications for these resources.
• Maintains a database for insurance-based processes, denials, appeals, Medicaid conversion, and related decisions.

Skills

Attention to detail

Computer proficiency

Effective communication

Team collaboration

Education

Associate's Degree in Social Work

Bachelor's Degree in Social Work preferred

Job description

Site: North Shore Medical Center, Inc.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 SummaryProvides support to case managers and clinical social workers with routine and regulatory clinical and administrative functions.Does this position require Patient Care?YesEssential 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.QualificationsEducation Associate's Degree Social Work required or Bachelor's Degree Social Work preferred Can this role accept experience in lieu of a degree? Yes Licenses and Credentials 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 RequirementsStanding Frequently (34-66%)Walking Frequently (34-66%)Sitting Occasionally (3-33%)Lifting Frequently (34-66%) 35lbs+ (w/assisted device)Carrying Frequently (34-66%) 20lbs - 35lbsPushing 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 TypeOnsiteWork Location81 Highland AvenueScheduled Weekly Hours40Employee TypeRegularWork ShiftDay (United States of America)Pay Range$22.35 - $25.28/HourlyGrade3At 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. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.EEO Statement:3200 North Shore Medical Center, 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 FrameworkAt 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.