Healthcare Case Management Professional
1 week ago
Mass General Brigham is seeking a highly skilled and detail-oriented Healthcare Case Management Professional for a nursing job in Everett, Massachusetts.
Job OverviewThis is an ongoing opportunity to work as part of our dynamic team, providing administrative support to Case Managers and Clinical Social Workers with routine and regulatory clinical and administrative functions.
The successful candidate will be responsible for supporting the discharge process through faxing, copying, and scanning of information, including referral sources, insurers, PCP offices; booking rooms for family-team meetings; assisting patients with securing new PCPs prior to discharge; researching DME providers.
The ideal candidate will also support the process of patient referral to SNF, home care, and outpatient, entering clinical information into the 4NEXT referral system, managing 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.
In addition, the candidate will research available community resources at the request of the CM or SW, assist the CM, SW, patient, and/or family with applications for community resources, such as PT1, handicap placards, and specialized funds; maintain a database for insurance-based processes, e.g., denials and appeals, Medicaid conversion requests and decisions.
Other duties may include contacting patients after discharge to complete the 'Post Discharge Follow-up Phone Call' process and documenting the calls per department protocol.
Key Responsibilities- Administrative support with discharge process, including faxing, copying, and scanning of information
- Support patient referral process to SNF, home care, and outpatient
- Enter clinical information into the 4NEXT referral system
- Manage communications regarding acceptance and bed offer or denial with facilities
- Research available community resources
- Assist with applications for community resources
- Maintain database for insurance-based processes
- Contact patients after discharge for post-discharge follow-up phone call
- A minimum of 1-2 years of clinical and/or community resource experience required
- Computer proficiency required, Microsoft office applications preferred
- Highly developed communications and interpersonal skills, working with diverse population
- Ability to work independently, be self-directed, and contribute as a member of a team
- Attention to detail
- Medical benefits
- Dental benefits
- Vision benefits
- Life insurance
- Employee assistance programs
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