Job Description

COVID VACCINATION (dose date on or after 10/3/23) NOW REQUIRED FOR THIS HEALTH SYSTEM. Exemption link in Trio compliance. IF APPROVED BY HEALTHSYSTEM TRAVELER WILL WEAR A MASK AT ALL TIMES WHILE ON SITE. To avoid delays in processing, please include traveler covid vaccination card/or intent to complete exemption link with profile submission. Thank you! AT LEAST TWO SPECIFIC INTERVIEW DATES/TIMES OF AVAILABILITY FOR INTERVIEW MUST BE ADDED TO PROFILE - PROFILES WILL NOT BE PRESENTED WITHOUT THIS INFORMATION. "ANYTIME" WILL NOT BE ACCEPTED. CORI/SIR SEARCHES ARE REQUIRED FOR THIS POSITION/TO BE STARTED ASAP UPON OFFER ACCEPTANCE/Candidate fills out, Facility conducts (Candidate cannot start assignment until these searches are resulted). Requested time off during the course of this assignment MUST be noted and verified at upload. RTO REQUESTS AFTER UPLOAD WILL NOT BE APPROVED!! The Case Manager is responsible for managing the healthcare needs, facilitation and achievement of quality and cost outcomes of all patients within Berkshire Medical Center, across the continuum. The case manager, utilizing a multidisciplinary team approach, negotiates, procures, coordinates and monitors services and resources needed by patients. The case manager is responsible for reviewing the patient at admission, and in some instances prior to admission, and concurrently throughout the hospital stay for the appropriate level of care and utilization of resources. The case manager will perform transition care planning activities to secure appropriate post hospital care arrangements and will monitor the patient during the course of their hospitalization. The case manager participates with the performance improvement initiatives undertaken by Berkshire Health SystemsAdditional Requirements: Organizational skills. Proven ability to analyze and present data. Computer literacy. Ability to plan, implements, and evaluate change.Data management skills preferredProven excellent interpersonal and communication skillsAbility to maintain confidentialityProven collaboration and negotiation skills with providers, patients, families, insurance organizations and government agenciesProven ability to work independentlyProven excellent organizational skillsDemonstrated ability to establish and maintain relationships with physiciansKnowledge of local community resources requiredKnowledge of Medicare, Medicaid, third party commercial payers and reimbursement requiredComputer experience required with proven ability to manage multiple open applicationsSkills in data comprehension, research, analysis, interpretation and judgement necessary to prepare a comprehensive summary report for files, management, legal and/or regulatory agencies upon requestNon-billable Orientation: 8hrsOT, Holiday Multipliers: 1.25%Call, Call-Back, Charge: Not applicable for this need Submission Requirements Masters in Social Work RequiredLCSW - Licensed Clinical Social Worker RequiredLICSW - Strongly Preferred3+ years clinical experience in acute care in areas such as internal medicine, surgery, orthopedics, mother/child, cardiology, oncology, psychiatry3+ years clinical experience in Rehab Setting, Home Health and Long-Term Care would be considered.Ability to perform a comprehensive admission and discharge risk assessment related to quality, financial, payer benefit allowances and limitations, risk management and patient satisfaction. Experience specializing in utilization management (levels of care knowledge and demonstrable competence with evidence based criteria tools), discharge planning to entities throughout a continuum of carePrevious care management or third party insurance review preferredCurrent knowledge of CMS (levels of care determinations), appeal rights & DPH regulations requiredCurrent knowledge of Kepro QIO (appeals) requiredKnowledge of regulatory and accreditation organizations such as Joint Commission, DPH and HealthGrades preferredProfile Requirements: Work HistorySkills Checklist (pertinent to position), current to 1 year 1 Supervisory Signed Reference (from within the past two years of employment)License/Certifications - Must be uploaded with profile Certification Requirements

BLS (AHA)

State License Requirements Massachusetts About the Facility BMC is a 298-bed teaching hospital and is ranked among the safest hospitals in the nation by The Leapfrog Group, which has given BMC Straight "A" grades since the inception of Leapfrog's patient safety program, one of only 42 hospitals in the nation to achieve this honor; and recipient of both the 2017 and 2018Healthgrades Patient Safety Excellence Award.Berkshire Medical Center offers a full continuum of medical specialties, including anesthesiology, dentistry, emergency medicine, family medicine, internal medicine, around the clock neurology and neurosurgery, obstetrics and gynecology, ophthalmology, orthopaedic surgery, otorhinolaryngology (ear, nose and throat), pathology, pediatrics, psychiatry, radiation oncology, radiology, rehabilitation, substance abuse, cardiac rehabilitation, a sleep lab and others. BMC has a state-of-the-art diagnostic imaging department, with MRI, high-speed CT, ultrasound, x-ray, mammography and more, providing 24-hour service.BMC has previously been honored by Healthgrades with its DistinguBMC Home.jpgished Hospital Award for Clinical Excellence and was one of Healthgrades America's Best Hospitals in 2016. BMC is a not for profit medical center fully accredited by The Joint Commission. As a medical center affiliated with Berkshire Health Systems, Berkshire Medical Center, its Hillcrest Campus and North Adams Campus serve all residents of Berkshire County, Massachusetts and communities in adjacent eastern New York, northwest Connecticut and southwest Vermont.You haven't submitted any candidates for this job.

Job Tags

Holiday work, Temporary work, Local area, Immediate start,

Similar Jobs