administrative coordinator

case manager (per diem)

case manager - boston

case manager - float

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

case manager

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

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

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)

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)

Abby Care

<div><h1 class="jobSectionHeader"><b>About Abby Care</b></h1><p>
Making family care possible. At Abby Care, we are tackling one of the most important and unsolved challenges of our time: family caregiving.<br>
<br>
Over 50 million Americans are family caregivers for loved ones without pay, tools, or support. Our mission is clear and ambitious: to train and employ family caregivers so they can get paid for the care they already provide at home.<br>
<br>
Abby Care is building a tech-powered, family-first care platform to efficiently deliver care, improve health outcomes, and provide the best-in-class experience nationwide.<br>
<br>
We are rapidly expanding our mission and looking for passionate team members to join. Abby Care has partnered with leading insurance plans, healthcare providers, and community organizations. We&rsquo;re supported by top, mission-driven VCs to empower families throughout the country.</p><p></p><h1 class="jobSectionHeader"><b>
The Role</b></h1><p>
We're looking for a passionate Registered Nurse to join our team as a <b>RN Case Manager</b>. This role will report into the Director of Nursing in Massachusetts. This is a <b>Full-Time </b>opportunity based in the <b>Boston North Shore/Lawrence</b> Area.</p><p>
The RN Case Manager at Abby Care provides the comprehensive care and coordination of services for patients within their caseload. This role requires a nurse with excellent organizational skills, strong communication abilities, and a dedication to providing high-quality patient care. The RN Case Manager will work closely with patients, families, Primary Care Physicians (PCPs), therapy providers, and internal support teams to ensure optimal patient outcomes.</p><p></p><h2 class="jobSectionHeader"><b>
Key Responsibilities:
</b></h2><ul><li><p><b>Patient Care and Coordination:</b></p><ul><li><p>
Manage a diverse caseload, ensuring quality patient care and efficient care coordination.</p></li><li><p>
Provide coaching, oversight, and support to Home Health Aides (HHAs) to ensure high-quality patient care and adherence to clinical standards.</p></li><li><p>
Develop and implement individualized care plans based on patient assessments and goals.</p></li><li><p>
Coordinate with PCPs, therapy providers, and internal support teams to ensure comprehensive care.</p></li><li><p>
Provide education and support to patients and families regarding their health care needs and treatment plans.</p></li></ul></li><li><p><b>
Clinical Documentation:</b></p><ul><li><p>
Maintain accurate and timely electronic charting, with a preference for real-time documentation.</p></li><li><p>
Ensure all documentation meets regulatory and Abby Care standards, with a minimum of 24-hour turnaround time.</p></li></ul></li><li><p><b>
Communication and Collaboration:</b></p><ul><li><p>
Establish and maintain effective communication with PCPs, therapy providers, and internal support teams.</p></li><li><p>
Escalate appropriate issues to Clinical Leads in a timely manner, such as order management and patient concerns.</p></li><li><p>
Participate in on-call rotation (approximately one weekend per month), holiday rotation, and possible phone triage night coverage during weekdays.</p></li></ul></li><li><p><b>
Quality Assurance:</b></p><ul><li><p>
Achieve caregiver satisfaction by providing high-quality, compassionate care and support.</p></li><li><p>
Monitor and work to improve patient readmission rates.</p></li><li><p>
Ensure extended visits remain within acceptable ranges and administrative tasks (e.g., mileage reimbursements) are completed thoroughly.</p></li></ul></li></ul><p></p><h2 class="jobSectionHeader"><b>
The Requirements:</b></h2><ul><li><p>
An Associate's Degree or A Baccalaureate School of Nursing Degree.</p></li><li><p>
Current and valid license as a Registered Nurse in the state of Massachusetts.</p></li><li><p>
2 years of experience as a Registered Nurse in a clinical setting; 1 year of home health experience preferred.</p></li><li><p>
Case management/supervisor experience and pediatric/adult care experience preferred.</p></li><li><p>
Knowledge of Medicaid paid family caregiving program and HHA scope of practice preferred (training provided if needed).</p></li><li><p>
Reliable transportation, valid driver's license, and current auto insurance required.</p></li><li><p>
Ability to work flexible hours, travel locally, and provide on-call service to patients/families.</p></li><li><p>
Knowledge of OASIS preferred (training provided if needed).</p></li></ul><p></p><h1 class="jobSectionHeader"><b>
Our Values</b></h1><ul><li><p><b>
Families First</b><br>
Redefining healthcare starts with how we treat the parents and children we serve. We go above and beyond for every family, building strong, lasting relationships. We continually ask ourselves, <i>&ldquo;Would we want this for our own families?&rdquo;</i></p></li><li><p><b>
Urgency with Precision</b><br>
Millions of families are waiting for care, and they cannot wait, therefore this is not your typical 9 to 5 job. We match their urgency with our own, delivering exceptional care without compromise. Here, speed and excellence go hand in hand<b>.
</b></p></li><li><p><b>Relentlessly Resourceful</b><br>
As an ambitious startup, we adapt quickly and make the most of limited time and resources. We solve challenges with creativity to deliver results without unnecessary complexity.</p></li><li><p><b>
Purpose with Positivity</b><br>
We take our mission seriously while never losing sight of the people behind the work. Respect, kindness, memes, and coffee make us stronger as a team and better for the families we serve.</p></li><li><p><b>
Driven to Redefine What&rsquo;s Possible</b><br>
We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care.
</p></li></ul><p></p><h1 class="jobSectionHeader"><b>Benefits:</b></h1><ul><li><p><b>
Competitive compensation packages</b> that reflect the value you bring. We reward our team for the impact of their work &ndash; full-time employees are eligible for an annual company performance bonus.</p></li><li><p><b>
Comprehensive health coverage that works for you.</b> We cover 90% of your premiums and 70% for your dependents, with multiple PPO plan options to choose from for medical, vision, dental, life, and short-term disability.</p></li><li><p><b>
Generous paid time off. </b>We provide policies that allow you to recharge along with 10 paid company holidays.
</p></li><li><p><b>Team bonding.</b> We love bringing our teams together. As a full-time employee, you&rsquo;ll get to connect, collaborate, and have fun through team activities and our annual company retreat.</p></li><li><p><b>
Financial savings benefits to support your future. </b>We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).</p></li><li><p><b>
Paid parental leave to support your growing family.</b> We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.</p></li></ul><p></p><p><i>
We are an equal opportunity employer and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.</i></p><p>
Compensation Range: $95K - $110K</p></div>

MA- Boston North Shore/Lawrence - RN 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><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><p><b>
Education</b><br>
<br>
Bachelor's Degree in related field<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]</p><p></p><p>
Registered Nurse [MA State License]</p><p><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>
0<p></p><div><div><div><div><div><div><div><p><b><br>
Employee Type</b></p></div></div></div></div></div></div></div>
Per Diem<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 (Per Diem)

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