Case Manager Non-RN - Steward Health Care System

Case Manager Non-RN - Care Management - Full Time - Days

About Steward Health Care
Over a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country's largest physician-led, minority-owned, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.

Based in Dallas, Steward currently operates more than 30 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, and Texas.

For more information, visit steward.org

St. Elizabeths Medical Center, a Boston University Teaching Hospital, provides patients and families access to some of Bostons most respected physicians and advanced treatments offering specialized care, including:

• Advanced Center for Cardiac Surgery
• da Vinci Robotic surgery program; Mako Robotic-Arm Assisted Surgery
• Level III Neonatal Intensive Care Unit (NICU)
• Award-winning bariatric surgery program
• Dana-Farber Cancer Institute at St. Elizabeth's Medical Center
• State-of-the-art emergency care with short wait times

Our medical staff, made up of some of the highest rated physicians in Boston, treats patients in our community practices in neighborhoods, including Allston, Boston, Brighton, Brookline, Newton, Watertown and Weston.

Benefits:

• 100% employer paid defined benefit retirement plan
• Lowest cost health insurance, high quality BCBS
• Grow with a health system that supports career advancement
• Competitive Pay & Salary Increases
• Employee Referral Program
• Locations close to home, that support work-life balance
• Affordable Medical, Dental and Vision Coverage
• 401k via Fidelity, for eligible employees, with company match
• Tuition Assistance / Reimbursement
• Family atmosphere and team approach that provides flexibility
• Opportunities to grow your career, and not change your employer
• And much more!

Position Summary:

The Case Management Coordinator is a multi-functional position, combining daily clinical/unit responsibilities with specifically focused coordination of case management activities and project work. Through these activities the case management technician provides essential support to the mission of the St. Elizabeth's Medical Center Care Coordination Department by supporting high quality care that is efficient, effective and strives to achieve patient/family satisfaction and the appropriate utilization of resources. The Care Management Coordinator works collaboratively with the discharge planner-social worker, the nurse case manager and the interdisciplinary team on the clinical unit for over 60 to 70 % of her role. In this capacity, the Case Management Coordinator meets compliance criteria, guidelines and regulatory requirements for patient management, including administering the CMS Important Message in a timely manner under the supervision of the social worker and case manager. In addition, the CM Coordinator works closely with the Discharge Planner and Case Manager to manage available resources to facilitate the discharge process, especially during times of staffing crisis.

The CM Coordinator manages daily interactions with the payers, fielding phone calls and interacting on a timely basis thru the distribution of insurance company communications.

The CM Coordinator supports the Director of Care Coordination by coordinating and maintaining key financial/clinical statistics and databases for the care coordination metrics. Backfills the administrative assistant when necessary (vacation or sick coverage, lunch breaks).

II. Accountability:

Reports to the Director of the Care Coordination Department

III. Qualifications/Education:

• Minimum of 2 years in an acute care hospital setting with direct patient/family contact
• Preferred Experience in a Case Management Department
• Demonstrated ability to communicate and interact with patients/families
• Preferred Experience as a Medical Secretary
• Understanding of Medical terminology
• Knowledge and proficient computer skills with demonstrated expertise with Word, Excel financial report creation and Power Point slide creation
• Experience or demonstrated Project Management ability with data collection and report creation and maintenance
• Preferred Associate and/or Baccalaureate degree, or actively pursuing

IV. Responsibilities:

• Start time is one hour later than the Administrative Assistant, to ensure departmental coverage/support
• Prints the Observation Report and prepares in chart to email Senior Leadership and Director of Care Coordination
• Enters authorization numbers in the Allscripts auth space and the UM note.
• Prepares to start clinical work on the patient care units, by reviewing the new admission reports, determining the distribution of the new admissions by payer-- who will be needing to sign the IM, under the supervision of the social worker and nurse case manager.
• Total of 60% of day is spent on clinical area, obtaining IM from all Medicare patients, using a "script" designed to promote patient/family understanding for the reason behind the IM.
• Provides immediate clinical case management discharge planning support to the social worker and nurse case manager, especially during staffing and other patient care crisis.
• Discharge Planning support may include: arranging patient transportation, durable medical equipment and at times speaking with home care and SNF's.
• Responsible for coordinating the Weekly Extended Stay Report, collaborating with all the staff, then working closely with the Director of Care Coordination for her completion
• Assists in gathering and organizing data by executing, submitting and distributing when necessary, some reports
• Coordinating Ambulance Billing with the Director of Care Coordination
• Preparing the Monthly Stats report with the Director of CC
• Participates in the "readiness" of all new orientees
• Covers for the Administrative Assistant in her absence, completing her most significant functions in an adequate and compliant manner
• Exhibit flexibility and willingness to respond to immediate departmental needs
• Act as an advocate for the patient/families in the clinical area, directing needs to the appropriate caregiver
• Demonstrate leadership abilities and the skill to work autonomously Participates in Staff Meetings, taking minutes in the absence of the Administrative Assistant
• Demonstrates professional work behavior, including complying with departmental and organizational policies and procedures, plus adheres to external agency requirements
• Maintains patient/family confidentiality in all settings

Working Conditions/Physical Demands:

• Clinical Environment 60-70% and desk/computer for remainder of day
• Standing, walking, bending and reaching daily
• Occasional lifting of light items
• Moderate periods of exposure to computers
• Internal and external applicants must be able to perform the essential job functions, either unaided or with the assistance of a reasonable accommodations to be determined by the organization on a case by case basis.

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.