Care Management Associate
75130BR
Pediatrics-GI/Nutrition
Status
Full-Time
Standard Hours per Week
40
Job Category
Administration
Regular, Temporary, Per Diem
Regular
Office/Site Location
Boston
Remote Eligibility
Part Remote/Hybrid
Job Posting Description
At Boston Children’s Hospital, the quality of our care – and our inclusive hospital working environment – lies in the diversity of our people. With patients from local communities and 160 countries around the world, we’re committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.
The DME Coordinator will be responsible for coordinating all aspects of the patient referral process for enteral nutrition and supplies; including working with insurance companies, durable medical equipment companies and patient families for delivery of products and supplies. The coordinator will work closely with clinical staff and provide accurate and timely non-clinical administrative support to facilitate ongoing patient care needs.
Principal Duties and Responsibilities Performs the duties and responsibilities as following:
- Answering, screening and routing phone and email inquiries from patients, families, clinical staff and external durable medical equipment companies
- Recording and documenting worklist of requests to ensure timely submission, approval, delivery
- Reviewing daily work assignments and prioritizing to ensure critical requests are addressed
- Facilitating all new and existing enteral nutrition patient referrals
- Corresponding with insurance and durable medical equipment companies to determine medical benefit, identify contracted companies and ensure enteral nutrition supplies are supported
- Accurately completing necessary insurance related documents including HCPCS Codes
- Printing prescriptions and clinical notes to support advocacy for medical necessity
- Electronically submitting related documents to durable medical equipment companies adhering to HIPPA guidelines and policies
- Assisting with timely and effective follow up communications with durable medical equipment companies, the patient family and providers
- Facilitating change from one durable medical equipment company to another as needed
- Continuously gathering information and keeping up to date with evolving insurance guidelines, requirements and formularies
• Actively promoting and fostering excellent relations with durable medical equipment representatives
- Demonstrating high-level critical thinking and problem resolution skills.
To qualify, you must have:
- High school diploma required. Some college or occupationally-specific education/training preferred.
- Minimum of 2 years of experience in a high volume administrative role with an emphasis on problem resolution among multiple internal and/or external parties. At least 1 of the 2 years should be in a healthcare or health insurance setting
- Strong organizational skills and attention to detail.
- An ability to manage multiple tasks within time constraints, as well as the ability to solve problems but with a keen sense of when to escalate for appropriate resolution.
Boston Children’s Hospital requires all employees to be vaccinated against COVID-19 and Flu, (unless you are eligible for a medical or religious exemption).
Boston Children’s Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
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