Case Manager III

About the Role

Manage patient cases with a high degree of clinical knowledge and expertise.

Responsibilities

• Assure that patients meet care criteria from admission through discharge.
• Initiate authorization with network providers.
• Maintain knowledge of clinical information for patient’s stay by review of documentation, participate in staffing, attend care conferences, and collaborate with other members of the treatment team.
• Perform concurrent review with network providers; monitor medical record documentation using knowledge of established guidelines to promote compliance and ensure quality for retrospective review by external review entities.
• Liaison with physician and other treatment team members to assure that all aspects of treatment are fully documented.
• Lead the flow of information between levels of care by collaborating with the admissions department, clinical and financial departments, and the patient and their family/guardian throughout the program to provide a smooth transition at discharge.
• Coordinate resources with other community services and agencies.
• Discuss appropriateness of a continued stay or continued care by the facility with the multi-disciplinary team, third-party case managers, physicians, and other departments.
• Perform other functions and tasks as assigned.

Requirements

• Bachelor’s degree in Social Work, Counseling, or related human service field required.
• Licensed health care professional with mental health experience (MSW; LCSW; RN; CNS; ARNP; Registered Mental Health Professional (MHP); Counselor (MA; MFT)) required.
• Three or more years' experience working in a behavioral health setting required.
• Licensure or certification for counseling, as may be required by the state in which the facility operates.
• CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).
• First aid may be required based on state or facility.