Care Transition Specialist Lead

4 weeks ago


Brighton, United States Mass General Brigham Full time
Care Transition Specialist Lead Job Description

Mass General Brigham is seeking a highly skilled Care Transition Specialist Lead to join our team in Brighton, MA.

Job Summary:

The Care Transition Specialist Lead will be responsible for managing system referrals, escalations, and supporting patient progression. This role will act as an advocate for patients and patient families, striving to support the hospital's aims for optimal resource management, high customer satisfaction, and high-quality care.

Key Responsibilities:

  • Assists with MGB Post-Acute Capacity referrals as directed by the Post-Acute Capacity team
  • Proactively facilitates referrals across Mass General Brigham, ordering of equipment (e.g. DME) and medication, completion of forms, and placement from inpatient and outpatient settings
  • Acts as a consultant to the hospital community, patients, and families regarding the placement process and access to community resources
  • Establishes homecare plans in conjunction with the CCM and documents the plan and progress in the medical record, including assistance with obtaining medications or DME needed at discharge
  • Coordinates and expedites final transfers with staff, patient, family, and facility
  • Updates staff on new facilities, services, and resources; and maintains a library of reference materials

Requirements:

  • Bachelor's Degree required and healthcare experience, preferably in extended care facilities and community agencies
  • Required, 3-yr experience in hospital discharge planning, long-term care facility, community health, or utilization review

Skills and Abilities:

  • Interpersonal skills to interact effectively with various levels of staff, patients, families, and community organizations
  • Extensive knowledge of regulations, community organization, state and federal systems, medical terminology, and levels of healthcare
  • Ability to manage a variable workload with the ability to constantly change priorities
  • Requires ability to work proactively and independently

About Mass General Brigham:

Mass General Brigham is a leading healthcare system that provides a welcoming environment to employees, patients, and families of diverse cultures, ethnic backgrounds, ages, lifestyles, and physical abilities. Our hospitals are consistently ranked as top hospitals by U.S. World News Report.

Benefits:

  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Life insurance
  • Employee assistance programs

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