Behavioral Mental Health Case Manager (RN)

About the role

Provides clinically and evidence-based patient care coordination for patients with behavioral and mental health (BMH) needs. Supports delivery of safe, effective, high-quality, and efficient patient care at Children’s Healthcare of Atlanta. Coordinates assessment, interdisciplinary discharge planning, and coordination of community-based services to assigned patients discharged from a Children's Healthcare of Atlanta facility.

Schedule

This role works 4 ten-hour days (7:00 AM–5:30 PM) with the opportunity to work remotely one day per week. Some weekend work may be required, as well as travel to other hospital locations.

Experience

• 3 years’ RN experience with a Bachelor of Science in Nursing (BSN)
• OR a current Children’s nurse with 5 years’ RN experience and an associate’s degree in nursing
• Current Children’s nurses with an associate’s degree in nursing must obtain a BSN within 2.5 years of hire date
• 3 years of broad clinical experience, predominantly in pediatric or behavioral and mental health care

Preferred Qualifications

• Master’s degree
• Experience in care coordination, case management, discharge planning, and utilization review
• Previous adult mental health experience helpful

Education

• Graduation from an accredited school of nursing

Certification Summary

• Licensure as a Registered Nurse in the State of Georgia or through the Enhanced Nurse Licensure Compact
• Basic Life Support (BLS) within 30 days of employment
• Registered Nurse case management certification from an approved accrediting organization within 1 year of meeting eligibility requirements

Knowledge, Skills and Abilities

• Excellent communication skills, both verbal and written
• Effective decision making/problem-solving skills and demonstration of creativity in problem-solving
• Influential leadership skills
• Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs
• Moderate to expert computer skills
• Working knowledge of financial aspects of third-party payors and reimbursement

Responsibilities

• Serves as a system clinical resource for Care Coordination Assistants during scheduled shift
• Completes initial screen of all patients on admission (within 24 hours) utilizing specific trigger criteria to identify needs related to care coordination and/or discharge planning
• Develops, initiates, and implements a robust transition care plan in collaboration with the clinical team for all applicable patients
• Cultivates and maintains effective interaction/communication with providers, nursing staff, social workers/counselors and others to drive care coordination process and facilitate continuity of patient care
• Communicates with all members of multidisciplinary team to facilitate care coordination process for assigned workload
• Oversees psychiatric residential treatment facility (PRTF) referral process, documentation, and submission, as necessary
• Communicates with home health agencies, third-party payors, acute and long-term psychiatric facilities, and other community resources as needed to coordinate discharge needs
• Ensures information sharing with Community Care Navigators regarding any BMH patients who require PRTF, meet high-utilizer criteria, or are identified as complex
• Facilitates and provides ongoing communication with patient/family and interdisciplinary staff to identify, escalate, and resolve potential barriers
• Facilitates care conferences, interdisciplinary rounds, and other meetings
• Serves as the clinical tiered support for EMS transport needs and escalations
• Completes medication prior authorizations and prescription arrangements, as necessary
• Participates in focused system initiatives and facilitates clinical practice guidelines at the patient level
• Performs outpatient and clinic care coordination and monitors care as patients transition between outpatient and inpatient services where appropriate
• Refers cases identified as risk management, peer review, or quality issues to appropriate personnel