Case Management Associate
Company: Spaulding Rehabilitation
Location: Cambridge
Posted on: May 4, 2024
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Job Description:
Case Management Associate - ( 3273920 )
Description
Summary:
Reporting to the Manager of Case Management and working under the
direction of the Case Managers (CM) and Social Work (SW) staffs,
the Case Management Associate provides support to Case Managers and
Clinical Social Workers with routine and regulatory clinical and
administrative functions.
Key Responsibilities:
Provides administrative support related to the discharge process
through faxing, copying, and scanning of information, including but
not limited to referral sources, insurers, PCP offices; booking
rooms for family-team meetings; assisting patients with securing
new PCP's prior to discharge; researching DME providers.
Supports the process of patient referral to SNF, home care, and
outpatient. The referral process includes entering clinical
information into the 4NEXT 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, such as PT1, handicap placards, and
specialized funds.
Maintains a database for insurance-based processes, e.g. denials
and appeals, Medicaid conversion requests and decisions.
Contacts patients after discharge to home to complete the "Post
Discharge Follow-up Phone Call" process and documents the calls per
department protocol.
Qualifications
Qualifications and Experience
Education/Degree
Preferred
Bachelor's of Social Work from an accredited institution preferred.
However, would substitute experience and complimentary of Associate
Degree
Experience
Required
A minimum of 1-2 years of clinical and/or community resource
experience required
Skills (Specific learned activity gained through training (e.g.
computer skills, keyboarding, presentation, CPR, ACLS, etc.)
Computer proficiency required. Microsoft office applications
preferred with ability to learn new software.
Highly developed communications and interpersonal skills, working
with diverse 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.
Attention to detail. EEO Statement:
SRN is committed to diversity in the workplace which begins with
respect and opportunity for all. SRN takes affirmative action to
ensure that equal employment opportunity is provided to all persons
regardless of race, religious creed, color, national origin, sex,
sexual orientation, gender identity, genetic information, age,
ancestry, veteran status, disability or any other basis that would
be inconsistent with any applicable ordinance or law. If you need a
reasonable accommodation in coming to or participating in the
interview process, please let us know.
Primary Location: MA-Cambridge-SHC Spaulding Hospital Cambridge
Work Locations:
SHC Spaulding Hospital Cambridge
1575 Cambridge Street
Cambridge 02138
Job: Social Services/Mental Health - Other
Organization: Spaulding Hospital-Boston &
Cambridge(SRN,SRH,SHC)
Schedule: Full-time
Standard Hours:: 40
Shift: Day Job
Posted Shift Description:: Monday - Friday 8:30am - 5pm
Employee Status: Regular
Recruiting Department:: SHC Case Management
Job Posting: Jan 30, 2024
Req ID: 3273920
Keywords: Spaulding Rehabilitation, Waltham , Case Management Associate, Executive , Cambridge, Massachusetts
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