Case Management Assistant

Job Title

Provides support to case managers and clinical social workers with routine and regulatory clinical and administrative functions.

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. 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.

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%)
• Vision - Far Constantly (67-100%)
• Vision - Near Constantly (67-100%)
• Talking Constantly (67-100%)
• Hearing Constantly (67-100%)

Work Location

81 Highland Avenue

Scheduled Weekly Hours

24

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$ - $25.28/Hourly

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.