Case Management Resource Specialist Per Diem
Boston, MA - USA
Job Summary
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
Summary:Responsible for assisting patients to arrange transportation to/from the hospital for ongoing medical treatment and/or to locate affordable accommodations and support groups. Works closely with the unit-based case manager to facilitate discharge plans to other psychiatric or medical settings. Other responsibilities may include making referrals to and organizing and disseminating information about a range of other related social resources.
Does this position require Patient Care Yes
Essential Functions:
-Researches information on community social resources.
-Maintains files of brochures information packets and applications for all types of community resources.
-Collaborates with social work staff and personnel from community agencies to obtain needed information.
-Assists in planning/implementing in-service presentations by and about community resources.
-Assesses patient/family understanding of available resources.
-Educates patients/families about appropriate resources and how to access them.
Qualifications
Education
High School Diploma or Equivalent required or Associates Degree Related Field of Study preferred
Can this role accept experience in lieu of a degree
No
Licenses and Credentials
Experience
related experience 2-3 years preferred
Knowledge Skills and Abilities
- Familiarity with medical terminology.
- Familiarity with community services/resources.
- Ability to maintain effective working relationships with patients/families.
- Knowledge of current community resources.
- Strong assessment and crisis intervention.
- Strong collaborative skills and a desire to work in a complex fast-paced environment.
- Excellent interpersonal skills.
- Excellent collaboration customer service and advocacy skills.
- Excellent written and verbal communication skills.
Additional Job Details (if applicable)
Every other weekend 8:30AM-5PM
Reporting to the CMRS Manager the Case Management Resource Specialist (CMRS) works collaboratively with the Discharge PlanningRN Case Managers; providing direct administrative support to the discharge planningprocesses and to the department. The person in this position will spend time on the clinical units and have direct interaction with patients and their families clinical and ancillary hospital staff and other internal and external customers. The CMRS must have strong communication skills and the ability to converse comfortably with patients and their caregivers department staff and unit-based staff. The position requires a high degree of flexibility independence and willingness to participate in multiple activities and provide support to all members of the Case Management Department.
Work collaboratively with Case Managers to support patients discharge plan and care needs along the continuum. This may include but is not limited to:
- Support and coordination of referrals to internal and external resources such as rehabilitation facilities VNAs hospice DME providers high tech vendors
- Actively manages 4NEXT referrals along the continuum of care including communication with facilities agencies and vendors to promote patient progression to discharge and effective transitions of care.
- Researches and secures out of state and in-network VNAs and facilities
- Researches/queries insurers for in-network providers for post-acute needs such as rehab facilities DME providers other contracted vendors.
- Communicates with insurance companies to expedite and/or manage delays with authorization for post-acute care and services.
- Secures DME and oxygen for post-acute needs; maps insurance and geography to identify appropriate vendors: assesses insurance benefits and coordinates the necessary paperwork with the external vendors and medical team for approval for equipment such as letters of medical necessity medical record documentation and prescriptions. Arranges for and tracks delivery of equipment prior to or post-discharge.
- Works collaboratively with the Case Manager Brewster Ambulance Services Transportation Coordinator and the VPNE care van ambassador to coordinate the various modes of discharge transportation.
- Supports the Capacity Coordination Center Case Manager to facilitate network-affiliate hospital to hospital repatriations and with the unit-based CM for non-affiliate repatriations.
- Assesses via electronic systems patients insurance plans and benefits such as MassHealth eligibility and Medicare benefits and facilitates coordination with Patient Financial Services
- Prepares explains to patients and documents delivery of theMedicare Important Message and Medicare Outpatient Observation Notice.
- Initiates and/or completes regulatory and other forms such as MassHealth Long-Term Care and DMH/DDS PASSR forms and processes the completed forms with the appropriate agencies.
- Identify and refer to community services as indicated
- Accesses and navigates the EMR to obtain essential information and documents CMRS progress notes and Resource Specialist Quick Notes per department standards.
Research community resources and programs available for patients and their caregivers including but not limited to:
- Assisted Living Facilities
- Legal and financial resources
- Private duty and block-nursing agencies
- Out of state providers
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$18.58 - $26.58/HourlyGrade
3EEO Statement:
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.
Required Experience:
IC
About Company
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.