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 Systems
Additional Requirements:

• Organizational skills. Proven ability to analyze and present data. Computer literacy. Ability to plan, implements, and evaluate change.
• Data management skills preferred
• Proven excellent interpersonal and communication skills
• Ability to maintain confidentiality
• Proven collaboration and negotiation skills with providers, patients, families, insurance organizations and government agencies
• Proven ability to work independently
• Proven excellent organizational skills
• Demonstrated ability to establish and maintain relationships with physicians
• Knowledge of local community resources required
• Knowledge of Medicare, Medicaid, third party commercial payers and reimbursement required
• Computer experience required with proven ability to manage multiple open applications
• Skills in data comprehension, research, analysis, interpretation and judgement necessary to prepare a comprehensive summary report for files, management, legal and/or regulatory agencies upon request

Non-billable Orientation: 8hrs
OT, Holiday Multipliers: 1.25%
Call, Call-Back, Charge: Not applicable for this need

Requirement description :

• Masters in Social Work Required
• LCSW - Licensed Clinical Social Worker Required
• LICSW - Strongly Preferred
• 3+ years clinical experience in acute care in areas such as internal medicine, surgery, orthopedics, mother/child, cardiology, oncology, psychiatry
• 3+ 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 care
• Previous care management or third party insurance review preferred
• Current knowledge of CMS (levels of care determinations), appeal rights & DPH regulations required
• Current knowledge of Kepro QIO (appeals) required
• Knowledge of regulatory and accreditation organizations such as Joint Commission, DPH and HealthGrades preferred

Profile Requirements:

• Work History
• Skills 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

Weekend Requirements : None
On Call Requirements : None