Clinical Coordinator
ForHealth Consulting at UMass Chan Medical School9 days ago
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OnsiteFull-timeSenior
Summary
ForHealth Consulting at UMass Chan Medical School is seeking a Clinical Coordinator to join their team in Westborough, MA. The role involves developing, prioritizing, and overseeing staff activities to promote care coordination for MassHealth members with complex medical needs.
About the Role
As a Clinical Coordinator, you will provide clinical direction and supervision to review teams, authorize services, and ensure compliance with MassHealth regulations. You will collaborate with various agencies, conduct training sessions, and lead performance improvement initiatives. The position requires travel to various facilities and homes to support clinical operations and maintain quality assurance.
About You
Required:
- BA/BS in a related field or equivalent experience required.
- RN licensed to practice in Massachusetts.
- 5-10 years of related work experience with at least 2 years supervisory or management experience in a clinical care coordination role.
- Ability to interpret appropriate regulations.
- Ability to work independently and collaboratively.
- Experience with Word and Excel and other desktop tools.
- Valid driver's license required.
Preferred:
- 3 years of related work experience with prior authorization and/or eligibility determinations for disabled, medically complex, home care, rehab or long term care populations strongly preferred.
- Knowledge of MassHealth Hearing and Appeals process preferred.
- Knowledge of MassHealth regulations preferred.
- Strong analytical and problem solving skills preferred.
- Professional certifications are preferred.
ForHealth Consulting at UMass Chan Medical School
ForHealth Consulting partners with purposeful organizations, including state Medicaid agencies and health and human services organizations, to make the healthcare experience better for all – more equitable, effective, and accessible. We know that to do this, we need to address every aspect of the system – how we pay for it, how we manage information, and how we deliver quality care to everyone. As part of UMass Chan Medical School, we leverage world-class expertise to create transformational solutions across the health and human services system. ForHealth Consulting believes in the power of collaboration and a shared purpose – together, we can make healthcare better.
Westborough, MA