Position Details
Temp Social Worker Social Worker Lbsw Apply
This role 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.
Requested time off during the course of this assignment MUST be noted and verified at upload. RTO REQUESTS AFTER UPLOAD WILL NOT BE APPROVED!!
Additional Requirements:
- 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.
- 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.
OT, Holiday Multipliers: 1.25%
Call, Call-Back, Charge: Not applicable for this need
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