case manager, denials and appeals, 40 hours (days)

case manager

case manager (per diem)

case manager - boston

case manager - float

case manager, denials and appeals, 40 hours (days) Jobs in Boston

case manager denials and appeals 40 hours days

Boston Medical Center

<div><div><div><h3 class="jobSectionHeader"><b>Case Manager, Denials and Appeals, 40 Hours (Days)</b></h3>
 <div></div><div><div><ul><li>46146
</li> </ul></div><div></div><div><ul><li>850 Harrison Avenue, Boston, Massachusetts
</li> </ul></div><div></div><div><ul><li>Full Time</li></ul></div></div><div></div><div><div><div><b><br>
</b></div></div><div></div><div><b>
</b></div></div><div>The UM RN will be responsible for review of potential transfers to the BMC System for tertiary care, in conjunction with the multidisciplinary care team, utilizing medical necessity screening tools to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests/procedures and an estimation of the patient&rsquo;s expected length of stay. This nurse secures authorization for the patient&rsquo;s clinical services through timely collaboration and communication with payers as required and follows the UR process, in addition to the pre-denial process as defined in the attached job description and in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization Review.<p></p><p><b>
POSITION SUMMARY:</b></p><p></p><p>
Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual&rsquo;s health needs, using communication and available resources to promote quality, cost-effective outcomes. The care manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source. This care manager is dedicated to handle the increased volume and to support the overall care management process and the department.</p><p></p><p><b>
Position: </b>Case Manager</p><p><b>
Department: </b>Denials and Appeals</p><p><b>
Schedule: </b>40 Hours (Days)</p><p></p><p><b>
JOB REQUIREMENTS</b></p><p></p><p><b>
EDUCATION:</b></p><p></p><p>
Graduate of an accredited BS Program in Nursing</p><p></p><p><b>
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED</b>:</p><ul>
<li><p>
Licensed to practice as a Registered Nurse in the commonwealth of Massachusetts</p></li>
<li><p>
CCM or related certification attained within 24 months from the hire date is preferred</p></li>
</ul><p></p><p><b>
EXPERIENCE:</b></p><ul>
<li><p>
3-5 years of diversified clinical experience is required</p></li>
<li><p>
A minimum of 2 years of previous experience involving judgment and decision making, preferably in a utilization management/case management position</p></li>
</ul><p></p><p><b>
KNOWLEDGE AND SKILLS:</b></p><ul>
<li><p>
Extensive background and knowledge of current medical/surgical patterns of practice.</p></li>
<li><p>
Medical terminology and standard medical abbreviations.</p></li>
<li><p>
Managed care concepts, the various health care delivery systems</p></li>
<li><p>
Methods for assessing an individual are level of physical/mental impairment, understanding of the physical and psychological characteristics of illness, and understanding of expected treatment.</p></li>
<li><p>
Confidentiality issues and the legal and ethical issues pertaining to them.</p></li>
<li><p>
ICD-9 and CPT nomenclature and the ability to interpret and convert this information, as applicable.</p></li>
<li><p>
Knowledge of benefits and various plan contracts, eligibility issues and requirements.</p></li>
<li><p>
Role and functional responsibilities of case management professional; case management program philosophy and purpose within Managed Care Program</p></li>
<li><p>
Excellent interpersonal, verbal and written communication and negotiations skills</p></li>
<li><p>
Strong analytical, data management and PC skills</p></li>
</ul><h3 class="jobSectionHeader"><b>
NursingCM</b></h3><p></p><p><b>
Compensation Range:</b></p>
$38.05- $75.33<p>
This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.</p><p></p><p>
Equal Opportunity Employer/Disabled/Veterans</p><p>
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or &ldquo;apps&rdquo; job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.</p></div></div></div></div>

Case Manager, Denials and Appeals, 40 Hours (Days)

Pine Street Inn

<div>
 <strong>
  Description:
  <br/>
  <br/>
 </strong>
 <strong>
  SCHEDULE:
 </strong>
 40 hours; Monday &ndash; Friday 9:00-5:30
 <br/>
 <br/>
 <strong>
  Pay:
 </strong>
 <strong>
  $23.48 - $26 per hour DOE (Salary ranges provided are based on relevant experience and skill set)
  <br/>
  <br/>
 </strong>
 <strong>
  LOCATION:
 </strong>
 444 Harrison Ave/PSI Shelters &amp; community-based work
 <br/>
 <br/>
 <strong>
  <strong>
   SUMMARY OF POSITION:
   <br/>
   <br/>
  </strong>
 </strong>
 The Housing Navigation Case Manager (HNCM) will work within a team of case managers to ensure that we develop and execute sustainable and expeditious housing plans for currently homeless guests. The Housing Navigation Case Manager will engage with homeless guests to reduce barriers to housing and develop individual housing plans that will rapidly lead to safe, affordable housing with the supports necessary to sustain achieved housing. The HNCM and their team will work under tight timeframes for accurately entering guest information into the Pine Street Inn&rsquo;s approved Homeless Management Information System (HMIS). Attention to detail and accuracy is critical in this position, The Housing Navigation Case Manager will provide exceptional customer service both internally and externally and will work in partnership with other PSI departments to provide integrated service delivery, which furthers our mission to eliminate homelessness.
 <br/>
 <br/>
 <strong>
  The Housing Navigation Case Manager will work from the following principles:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   All people experiencing homelessness, regardless of their housing history and duration of homelessness, can achieve housing stability in permanent housing.
  </li>
  <li>
   Everyone is &ldquo;housing ready.&rdquo; Sobriety, compliance in treatment, or even a clean criminal history is not necessary to succeed in housing. Rather, homelessness programs and housing providers must be &ldquo;consumer ready&rdquo;.
  </li>
  <li>
   Leverage guests&rsquo; strengths, assets, and connections to move quickly out of shelters and to any other housing.
  </li>
  <li>
   Recognize the impact of violence and victimization on development and coping strategies
  </li>
  <li>
   Employ an empowerment model
  </li>
  <li>
   Maximize guest choices and control over her/his recovery based in a relational collaboration
  </li>
  <li>
   Create an atmosphere that is respectful of the guests&rsquo; need for safety, respect, and acceptance
  </li>
  <li>
   Emphasize the guests&rsquo; strengths, highlighting adaptations over symptoms and resilience over pathology
  </li>
  <li>
   Minimize the possibilities of re-traumatization
  </li>
  <li>
   Strive to be culturally competent and to understand each person in the context of his or her life experiences and cultural background
  </li>
  <li>
   Solicit guest input and involve guests in designing and evaluating services
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Requirements:
  <br/>
  <br/>
 </strong>
 <strong>
  EDUCATION/TRAINING:
  <br/>
  <br/>
 </strong>
 <strong>
  Required:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   BSW, BA or BS in a human service-related field [can be substituted for High School Diploma and at least three (3) years of equivalent experience in a social service setting]
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   PREFERRED:
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Bilingual &ndash; Spanish/English and/or Haitian-Creole
  </li>
  <li>
   Certification, training, or formal education in counseling and/or case management
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   KNOWLEDGE/EXPERIENCE:
   <br/>
   <br/>
  </strong>
 </strong>
 REQUIRED:
 <br/>
 <br/>
 <ul>
  <li>
   A minimum of two (2) years of experience delivering services to a challenged population often struggling with addiction and untreated or under-treated mental health concerns
  </li>
  <li>
   Strong computer and math skills - including familiarity with MS Word and Excel Experience
  </li>
  <li>
   Practical experience in working collaboratively with homeless individuals creating housing plans and individual service plans
  </li>
  <li>
   Experience accessing housing opportunities and subsidy programs for homeless individuals
  </li>
  <li>
   Knowledge of the issues related to homelessness and housing
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   PREFERRED:
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Knowledge and experience utilizing Motivational Interviewing, Trauma-Informed Care, Harm Reduction, Housing First, and Change Theory in practice
  </li>
  <li>
   Experience with helping individuals with budgeting
  </li>
 </ul>
</div>


Housing Placement Case Manager (Housing Navigation)

Native American LifeLines

<div><p><b>POSITION SUMMARY</b></p><p>
Under the supervision of the Clinical Director (future Community Health and Wellness Director), the Case Manager partners with clients and the community to improve the wellness and health outcomes for Native Americans that are in our service area. The Case Manager will perform case management activities focused on linking clients to behavioral health care, psychosocial supports, and appropriate community resources. The Case Manager will routinely perform client intakes, service planning, safety planning, data collection, and documentation in our Electronic Health Records system.</p><p><b>
ESSENTIAL DUTIES</b></p><p>
Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions of the position.</p><ul><li><p>
Complete client intakes and plan case management goals.</p></li><li><p>
Proactively identify social supports needed for long-term stability of clients and work with clients to build a pathway to accessing such supports.</p></li><li><p>
Engage clients and build relationships with empathy and compassion.</p></li><li><p>
Engage team members in problem solving around clients' cases or care.</p></li><li><p>
Assist clients in applying for financial, housing, and other benefits, including completing housing, disability benefits, and employment related applications. Identify and support the client's use of appropriate external resources.</p></li><li><p>
Initiate and monitor client referrals to completion.</p></li><li><p>
Appointment reminders, follow-up, and transportation scheduling.</p></li><li><p>
Monitor, collect, and enter all documentation thoroughly and in accordance with required timeframes within the Electronic Medical Records (EMR)/Electronic Health Records (EHR) system, including but not limited to: intakes, assessments, treatment plans, progress notes, referrals, case consultations, and discharge summaries.</p></li><li><p>
Collect and report Government Performance and Results Act (GPRA) data.</p></li><li><p>
Collect site-specific data and assist in preparing monthly and annual service report.</p></li><li><p>
Assist in development and implementation of health promotion/disease prevention events.</p></li><li><p>
Represents Native American LifeLines of Baltimore at community outreach events, including some evening or weekend events.</p></li><li><p>
Participates in weekly case supervision with Clinical Director/Community Health and Wellness Director, and staff and site meetings.</p></li><li><p>
Create database of community resources and assist with social marketing.</p></li></ul><p><b>
BENEFITS</b><br>
In addition to salary, you receive the following benefits:</p><ul><li><p>
Medical, dental, and vision coverage paid at 100% for the employee, starting on the 1st of the month after the hire date.</p></li><li><p>
EAP (Employee Assistance Program), STD/LTD, AD&amp;D, Life coverage</p></li><li><p>
3% match SIMPLE IRA (after 1 year)</p></li><li><p>
Assistance with applicable licensure fees as the budget allows</p></li><li><p>
Assistance with continuing education credits as the budget allows</p></li></ul><p><b>
PTO/HOLIDAYS</b><br>
Staff health and wellbeing is central to our ability to aid the community in achieving their own wellness goals. In addition to regular staff care activities, NAL offers a generous combination of sick and personal hours, accrued vacation, and 16 paid holidays annually.</p><p><b>
EDUCATION AND/OR EXPERIENCE</b></p><ul><li><p>
This role requires a Bachelor&rsquo;s degree in Social Work, Public Health, Psychology, Human Services, or other health-related field. A Master's Degree is preferred.</p></li><li><p>
Two years of Case Manager experience is preferred.</p></li><li><p>
Must successfully complete a background check.</p></li><li><p>
Proficient in Microsoft Office suite.</p></li><li><p>
Ability to work independently</p></li><li><p>
Valid Driver&rsquo;s License and the ability to travel and transport.</p></li><li><p>
Strong professional ethics.</p></li><li><p>
Ability to communicate effectively both in writing and verbally.</p></li><li><p>
Knowledge of Affordable Care Act/Indian Health Care Improvement Act.</p></li><li><p>
Knowledge of American Indian health and social concerns.</p></li><li><p>
Knowledge of Maryland and Massachusetts health care systems and community resources.</p></li><li><p>
CPR certification highly desired.</p></li></ul></div>

Case Manager - Boston

Boston Children's Hospital

<div><div><div><div>84679BR</div>
</div><div><div>Orthopedic Surgery and Research
</div></div><div><p><b>Job Posting Description</b></p>
<div><b>Position Summary:</b><br>
This is a CRA opportunity in Translational research. This is a competitive 2-year initiative for recent college graduates aspiring to leadership roles in medicine. It provides hands-on training in clinical practice, research, and leadership within the Orthopedics &amp; Sports Medicine department. Participants will have the opportunity to work alongside renowned orthopedic surgeons and researchers.<br>
<br>
<b>Key Responsibilities:
</b><ul><li>Clinical Research: Involves subject recruitment, IRB submissions, data analysis, and manuscript preparation.</li><li>
Study Design &amp; Analytics: Exposure to research methodology, statistics, and clinical science study design.</li><li>
Research Ethics: Training in human subjects, protections and management of multicenter registries.</li><li>
Clinical Exposure Scribe Role: Participate in patient visits, documentation, and learn clinical decision-making and physical exam techniques.</li><li>
Shadowing &amp; Mentorship: Collaborate with leading orthopedic surgeons; attend lectures, case reviews, and conferences.</li><li>
Educational Opportunities Daily Lecture Series: Covers orthopedic topics and research skills.</li><li>
Weekly &amp; Quarterly Events: Includes case reviews, journal clubs, and visiting professor seminars.</li><li>
Research Engagement: Opportunities for co-authorship on publications and presentations at regional/national conferences.</li><li>
Mentorship and Scholar Support Mentorship: One-on-one guidance from top faculty, with regular career coaching and project feedback. This program emphasizes building futures and advancing knowledge through dedicated faculty support.</li></ul>
<br>
<b>Minimum Qualifications</b><br>
<b>Education:</b><ul><li>
A Bachelor&rsquo;s Degree is required.</li></ul><b>
Experience:</b><ul><li>
Analytical skills to gather and interpret data, excellent organizational skills and attention to detail.</li><li>
Effective communication and writing skills to provide critical information to team members, patients, and families with ability to triage and escalate concerns to appropriate leadership.</li><li>
Problem-solving, troubleshooting abilities and resourcefulness.</li></ul></div>
</div><div><p><b>Status</b></p>
<div>Full-Time</div>
</div><div><p><b>Regular, Temporary, Per Diem</b></p>
<div>Regular
</div></div><div><p><b>Standard Hours per Week</b></p>
<div>40
</div></div><div><p><b>Pay Range</b></p>
<div>$41246.40-$61339.20 Annual</div>
</div><div><p><b>Office/Site Location</b></p>
<div>Boston</div>
</div><div><p><b>Job Posting Category</b></p>
<div>Research</div>
</div><div><p><b>Remote Eligibility
</b></p><div>Part Remote/Hybrid</div></div></div></div><div></div>

Clinical Research Assistant - MCD Scholar

Beth Israel Lahey Health

Boston, MA &bull; Beth Israel Deaconess Medical Center &bull; Full-time &bull; Day
<br><div><p><b>When you join the growing BILH team, you're not just taking a job, you&rsquo;re making a difference in people&rsquo;s lives.</b></p>
<p></p>
<p>Under supervision and in accordance with department policies and procedures, the Lead Consult Coordinator organizes and coordinates the pathology consultation service while serving as the functional lead for the consultation coordination team. This role reviews and triages incoming consultation materials according to established protocols, ensures accurate and timely processing of consult requests, and provides day-to-day guidance and issue escalation support to maintain consistent workflows and high-quality service.</p>
<p></p>
<p><b>Job Description:</b></p>
<p><b>
Responsibilities:</b></p>
<ul>
<li>Prioritize decision-making activities in accordance with guidelines defined by department. Work closely with physician staff/fellows to follow up on all requests including communication with outside institutions.</li>
<li>Coordinate consultation service to include over 2500 incoming consultations per year (national and international second opinion requests).</li>
<li>Processes outside pathology consultations (create registration, visits, and accession numbers/log in cases into the computer).</li>
<li>Review incoming materials to systematically organize and arrange slides and blocks based on pathology protocol to discern appropriate medical triage.</li>
<li>Input case information into appropriate tracking mechanisms</li>
<li>Register patient demographics to include insurance information. Obtain and scan payment authorizations to set up financial information/billing for outside requests for second opinion.</li>
<li>Liaise with referring entities to obtain missing information or additional pathology material, as well as updating on case status when requested.</li>
<li>Serve as the functional lead for the Pathology Consultation Coordination team, providing day-to-day guidance and support to consultation coordinators while remaining actively engaged in operational work.</li>
<li>Act as the first point of escalation for consult-related questions, issues, or exceptions; perform initial problem resolution and escalate to the Manager, Pathology Support Services as appropriate.</li>
<li>Track adherence to standardized consult workflows, protocols, and best practices; promote consistency and accuracy across all consultation activities.</li>
<li>Monitor and maintain the quality and completeness of consult logs, trackers, and related documentation; identify trends, gaps, or risks and communicate findings to Manager.</li>
<li>Support workload distribution and coverage planning to maintain timely turnaround times and operational continuity during periods of growth, absence, or transition, as well as identifying workload imbalances.</li>
<li>Monitor consult volume, turnaround times, and error trends; proactively flag concerns and opportunities for improvement to the Manager.</li>
<li>Support process improvement initiatives, including co-leading projects, testing workflow changes, and assisting with implementation of new tools, systems, or procedures.</li>
<li>Provide onboarding and training support for new consultation coordinators, including hands-on training and shadowing.</li>
<li>Maintain and update training materials, reference guides, and standard operating procedures to ensure knowledge continuity and reduce variability in performance.</li>
<li>Serve as a liaison between frontline staff, physician teams, and departmental leadership to facilitate communication, issue resolution, and alignment of expectations.</li>
<li>Contribute to the development of a scalable consult coordination model that supports increased consult volume and future staffing growth.</li>
<li>Support team engagement and cohesion by modeling best practices, professionalism, and a high standard of customer service.</li>
</ul>
<p><b>Required Qualifications:</b></p>
<ul>
<li>High School diploma or GED required.</li>
<li>2-5 years related work experience required in administration and transcription, preferably with a healthcare or anatomical pathology background.</li>
<li>Outcome of work impacts patient care, operations of work unit and department. Responsible for specific, defined results directly related to own job responsibilities.</li>
<li>Work requires the employee to possess outstanding organizational skills, to effectively problem-solve, to follow instructions, and to complete tasks requiring multiple steps and meet deadlines.</li>
<li>Work requires wide-range knowledge of medical terminology; the ability to type and to proof medical documents. Work requires attention to detail, procedures, and physicians&rsquo; preferences.</li>
<li>Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.</li>
</ul>
<p><b>Competencies:</b></p>
<ul>
<li>Written Communications: Ability to communicate clearly and effectively in written English with internal and external customers.</li>
<li>Oral Communications: Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.</li>
<li>Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.</li>
<li>Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, collaborating for coverage and other gaps in service coverage, and respecting team members.</li></ul><br>
<p></p>
<p></p>
<p><b>Pay Range:
</b></p><p>$24.26 &ndash; $32.64</p>
<p>
The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.</p>
<p></p>
<h2 class="jobSectionHeader"><b>As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.</b></h2>
<p></p>
<h2 class="jobSectionHeader"><b>More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.</b></h2>
<p></p>
<h2 class="jobSectionHeader"><b>Equal Opportunity Employer/Veterans/Disabled</b></h2></div><p></p>
<br><div><h3 class="jobSectionHeader"><b>Job details</b></h3>
<ul><li><div><b>Employment:</b> Full-time</div></li>
<li><div><b>Hours/Week:</b> 40</div></li>
<li><div><b>Shift:</b> Day</div></li>
<li><div><b>Category:</b> Laboratory</div></li>
<li><div><b>Pay Range:</b> $24.26 - $32.64</div></li>
<li><div><b>FLSA:</b> Non-Exempt</div></li>
<li><div><b>Req ID:</b> JR90973</div></li></ul></div>

Lead Consult Coordinator – BIDMC

Spaulding Rehabilitation Hospital

<div>Site: The Spaulding Rehabilitation Hospital Corporation<p></p><p><br>
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.</p><br>
<p></p>
This full-time, day shift Case Manager is working at our acute care rehab location in Charlestown on the stroke unit.<br>
<br>
*We're offering a generous sign-on bonus of up to $10,000 to welcome you to our team. Recognizing and valuing exceptional talent, we're eager to discuss the exciting details of this bonus during our interview process.*<p></p><p><b><br>
Job Summary</b></p>
Summary<br>
Responsible for completing intake interviews; determining need for medical and psycho-social evaluations; reviewing therapist and physician evaluations, care objectives, and plans; coordinating services being provided; advocating for needed services and entitlements.<br>
<br>
Essential Functions<br>
Complete psychosocial assessments covering psychological, social and environmental concerns, including evaluation of mental status.<br>
<br>
Review daily referrals and screenings of clients.<br>
<br>
Audit case file on a regular basis for completeness and accuracy.<br>
<br>
Assist in discharge planning as required<br>
<br>
Serves and protects the hospital community by adhering to professional standards, hospital care policies and procedures, federal, state, and local requirements, and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards.<br>
<br>
Initiate a complete assessment, to gather and/or verify relevant baseline data, identify their understanding and expectations of their stay, and identify any potential issues/barriers to arranging post inpatient care.<br>
<br>
Proactively work with patient, caregiver, and the interdisciplinary team, including community providers of medical services, as appropriate, to develop a realistic and timely plan for post inpatient care.<br>
<br>
Identify and coordinate appropriate resources post discharge for patients requiring homecare, outpatient, or placement in an alternate level of care.<br>
<br>
Perform ongoing evaluation for appropriateness for the facility&rsquo;s level of care by applying knowledge of level of care criteria with active collaboration with patients insurance payer<br>
<br>
Comply with all applicable State and Federal regulations as well as other credentialing bodies, including but not limited to, Joint Commission and CARF, regarding the case management process.<br>
<br>
Spaulding serves the acute rehabilitation population: stroke, traumatic orthopedic injury burns, spinal cord injury, brain injury.<br>
<br>
Required for All Jobs<br>
Performs other duties as assigned<br>
<br>
Complies with all policies and standards<br>
<br>
Does this position require Patient Care (indirect/direct)? Yes<p></p><div><div><div><div><div><div><div><p><b><br>
Qualifications</b></p></div></div></div></div></div></div></div><div><div><div><p><b>
Education</b></p><p>
Master's Degree Social Work required or</p><p>
Master's Degree Related Field of Study preferred or</p><p>
Master's Degree Mental Health required</p><p></p><p>
Can this role accept experience in lieu of a degree? No</p><p></p><p><b>
Licenses and Credentials</b></p><p>
Social Worker, Licensed Clinical [LCSW - State License]</p><p>
Social Worker, Licensed Independent Clinical [LICSW - State License]</p><p>
Occupational Therapist [State License]</p><p>
Physical Therapist [State License]</p><p>
Certified Rehabilitation Counselor [CRC]</p><p>
Licensed Mental Health Counselor [State License]</p><p>
Licensed Rehabilitation Counselor [Massachusetts]</p><p>
Respiratory Therapist [Massachusetts]</p><p>
Registered Nurse [RN - Massachusetts]</p><p></p><p><b>
Experience</b></p><p>
Case management, utilization review, or discharge planning experience 2-3 years preferred</p><p></p><p><b>
Knowledge, Skills &amp; Abilities</b></p><p>
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.</p><p>
Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.</p><p>
Ability to establish strong rapport and relationships with patients and staff.</p><p>
Proficient in Microsoft Office and industry related software programs.</p><p>
Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.</p><p>
Ability to maintain client and staff confidentiality.</p><p>
Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care.</p><p>
Knowledge of Healthcare and Managed Care preferred.</p></div></div></div><p></p><div><div><div><div><div><div><div><p><b><br>
Additional Job Details (if applicable)</b></p></div></div></div></div></div></div></div><p></p><div><div><div><div><div><div><div><p><b><br>
Remote Type</b></p></div></div></div></div></div></div></div>
Onsite<p></p><div><div><div><div><div><div><div><p><b><br>
Work Location</b></p></div></div></div></div></div></div></div>
300 First Avenue<p></p><div><div><div><div><div><div><div><p><b><br>
Scheduled Weekly Hours</b></p></div></div></div></div></div></div></div>
40<p></p><div><div><div><div><div><div><div><p><b><br>
Employee Type</b></p></div></div></div></div></div></div></div>
Regular<p></p><div><div><div><div><div><div><div><p><b><br>
Work Shift</b></p></div></div></div></div></div></div></div>
Day (United States of America)<p></p><p><b><br>
Pay Range</b></p>
$58,656.00 - $142,448.80/Annual<p></p><p><b><br>
Grade</b></p>
98TEMP<br>
<p></p>
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.<p></p><div><div><div><div><div><div><div><p><b><br>
EEO Statement:</b></p></div></div></div></div></div></div></div>
1400 The Spaulding Rehabilitation Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran&rsquo;s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.<p></p><h2 class="jobSectionHeader"><b><br>
Mass General Brigham Competency Framework</b></h2><div><div><p>
At Mass General Brigham, our competency framework defines what effective leadership &ldquo;looks like&rdquo; 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.</p></div></div></div>

Case Manager

<div>Site: The Spaulding Rehabilitation Hospital Corporation<p></p><p><br>
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.</p><br>
<p></p>
This full-time, day shift position will be a float Case Manager covering our two acute care hospitals in Charlestown and the Cape.<br>
<br>
*We're offering a generous sign-on bonus of up to $10,000 to welcome you to our team. Recognizing and valuing exceptional talent, we're eager to discuss the exciting details of this bonus during our interview process.*<p></p><p><b><br>
Job Summary</b></p>
Summary<br>
Responsible for completing intake interviews; determining need for medical and psycho-social evaluations; reviewing therapist and physician evaluations, care objectives, and plans; coordinating services being provided; advocating for needed services and entitlements.<br>
<br>
Essential Functions<br>
Complete psychosocial assessments covering psychological, social and environmental concerns, including evaluation of mental status.<br>
<br>
Review daily referrals and screenings of clients.<br>
<br>
Audit case file on a regular basis for completeness and accuracy.<br>
<br>
Assist in discharge planning as required<br>
<br>
Serves and protects the hospital community by adhering to professional standards, hospital care policies and procedures, federal, state, and local requirements, and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards.<br>
<br>
Initiate a complete assessment, to gather and/or verify relevant baseline data, identify their understanding and expectations of their stay, and identify any potential issues/barriers to arranging post inpatient care.<br>
<br>
Proactively work with patient, caregiver, and the interdisciplinary team, including community providers of medical services, as appropriate, to develop a realistic and timely plan for post inpatient care.<br>
<br>
Identify and coordinate appropriate resources post discharge for patients requiring homecare, outpatient, or placement in an alternate level of care.<br>
<br>
Perform ongoing evaluation for appropriateness for the facility&rsquo;s level of care by applying knowledge of level of care criteria with active collaboration with patients insurance payer<br>
<br>
Comply with all applicable State and Federal regulations as well as other credentialing bodies, including but not limited to, Joint Commission and CARF, regarding the case management process.<br>
<br>
Spaulding serves the acute rehabilitation population: stroke, traumatic orthopedic injury burns, spinal cord injury, brain injury.<br>
<br>
Required for All Jobs<br>
Performs other duties as assigned<br>
Complies with all policies and standards<br>
Does this position require Patient Care (indirect/direct)? Yes<p></p><div><div><div><div><div><div><div><p><b><br>
Qualifications</b></p></div></div></div></div></div></div></div><p><b>
Education</b><br>
<br>
Master's Degree Social Work required or<br>
<br>
Master's Degree Related Field of Study preferred or<br>
<br>
Master's Degree Mental Health required<br>
<br>
Can this role accept experience in lieu of a degree? No<br>
<br>
<b>Licenses and Credentials</b><br>
<br>
Social Worker, Licensed Clinical [LCSW - State License]<br>
<br>
Social Worker, Licensed Independent Clinical [LICSW - State License]<br>
<br>
Occupational Therapist [State License]<br>
<br>
Physical Therapist [State License]<br>
<br>
Certified Rehabilitation Counselor [CRC]<br>
<br>
Licensed Mental Health Counselor [State License]<br>
<br>
Licensed Rehabilitation Counselor [Massachusetts]<br>
<br>
Respiratory Therapist [Massachusetts]</p><p></p><p>
Registered Nurse [RN - Massachusetts]<br>
<br>
<b>Experience</b><br>
<br>
Case management, utilization review, or discharge planning experience 2-3 years preferred<br>
<br>
<b>Knowledge, Skills &amp; Abilities</b><br>
<br>
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.<br>
<br>
Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.<br>
<br>
Ability to establish strong rapport and relationships with patients and staff.<br>
<br>
Proficient in Microsoft Office and industry related software programs.<br>
<br>
Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.<br>
<br>
Ability to maintain client and staff confidentiality.<br>
<br>
Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care.<br>
<br>
Knowledge of Healthcare and Managed Care preferred.</p><p></p><div><div><div><div><div><div><div><p><b><br>
Additional Job Details (if applicable)</b></p></div></div></div></div></div></div></div><b>
Physical Requirements</b><br>
<br>
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%)<p></p><div><div><div><div><div><div><div><p><b><br>
Remote Type</b></p></div></div></div></div></div></div></div>
Onsite<p></p><div><div><div><div><div><div><div><p><b><br>
Work Location</b></p></div></div></div></div></div></div></div>
300 First Avenue<p></p><div><div><div><div><div><div><div><p><b><br>
Scheduled Weekly Hours</b></p></div></div></div></div></div></div></div>
40<p></p><div><div><div><div><div><div><div><p><b><br>
Employee Type</b></p></div></div></div></div></div></div></div>
Regular<p></p><div><div><div><div><div><div><div><p><b><br>
Work Shift</b></p></div></div></div></div></div></div></div>
Day (United States of America)<p></p><p><b><br>
Pay Range</b></p>
$58,656.00 - $142,448.80/Annual<p></p><p><b><br>
Grade</b></p>
98TEMP<br>
<p></p>
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.<p></p><div><div><div><div><div><div><div><p><b><br>
EEO Statement:</b></p></div></div></div></div></div></div></div>
1400 The Spaulding Rehabilitation Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran&rsquo;s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.<p></p><h2 class="jobSectionHeader"><b><br>
Mass General Brigham Competency Framework</b></h2><div><div><p>
At Mass General Brigham, our competency framework defines what effective leadership &ldquo;looks like&rdquo; 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.</p></div></div></div>

Case Manager - Float

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