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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 Summary Provides support to case managers and clinical social workers with routine and regulatory clinical and administrative functions.
Does this position require Patient Care? Yes
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. Additional Job Details (if applicable) 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%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%)
