Patient Care Navigator / Case Manager

About the role

WBI Outpatient & Telehealth Clinic provides intensive and targeted clinical therapeutic services to improve the continuum of care for patients and to provide access to mental/behavioral healthcare services to the underserved. The Patient Care Navigator serves as the first contact with patients and their families and is responsible for completing the initial telehealth consult, assisting in case management functions, coordinating outpatient services, securing patient insurance and payment processes, participating as a member of the treatment team, and scheduling and coordinating patient management needs from intake to discharge. The Patient Care Navigator / Case Manager provides accurate and timely communication, documentation, and problem-solving to referral sources as well as the treatment team.

Responsibilities

• Meet with potential patients to discuss the benefits of outpatient services as part of their continuum of care.
• Serve as support staff (milieu manager) for the virtual Intensive Outpatient Program (IOP).
• Track and organize all IOP referrals, admission/enrollment, and discharge needs.
• Recruit and register step-in patients for IOP and other outpatient services.
• Act as intermediary between payer sources, patient/guardian, administrative coordinator, and utilization review.
• Participate in inpatient treatment team meetings to support the step-down process to outpatient services.
• Provide step-down groups in the inpatient setting to support connection with outpatient services.
• Ensure accurate and timely data entry for reporting purposes and formulate patient file systems and organization.
• Communicate regularly and timely with relevant members of the treatment team and family members as appropriate.
• Provide case management services specific to patient eligibility, enrollment, and discharge.
• Participate in daily and weekly inpatient staffing meetings to coordinate step-down services for acute and residential patients.
• Serve as telemilieu manager as needed for group therapy and mental health intensive outpatient programs.
• Assist in developing strategies, goals, and objectives related to the step-down process.
• Relate to patients in an age-appropriate manner and support scheduling and enrollment for IOP and other outpatient services.
• Cross-train with reception/front desk to support breaks and time off.
• Complete data entry for trending report purposes in multiple record/tracking platforms and identify and communicate data-driven trends in the step-down process.
• Ensure the collection and entry of data as it pertains to patient eligibility and review and report on data and processes to the outpatient team.
• Maintain communication as needed with county and state agencies and uphold necessary documentation of all case management services and quality of care issues.
• Support physicians/psychiatrists with documentation assistance and needs, and assist the Utilization Review team with reviews and documentation.
• Contribute to the effective functioning of assigned programs and facility-wide activities and services, report unsafe conditions, and ensure patient rights are upheld.
• Ensure the safe and therapeutic functioning of the tele-milieu, serve as Milieu Manager as assigned, and create tele-therapy spaces to meet privacy standards and ensure patient safety.
• Provide telehealth services comparable to in-person services.
• Collaborate effectively with physicians and other clinical disciplines in making decisions regarding each patient’s need for care.
• Communicate with the treatment team and other providers to ensure continuity of care and expedite the flow of services and transitions between levels of care.
• Intervene effectively in unusual and complex patient/family situations and provide accurate safety support in crisis situations, participating in debriefing after crises.
• Update and coordinate tele-therapy services to meet patient needs and communicate effectively with patients, families, healthcare team members, and community providers regarding patient status and progress.
• Interact and communicate with community agencies in assessment of and service to patients in a timely manner, provide liaison and referral services, and appear in court when requested or subpoenaed.
• Comply with required standards for medical/legal reporting situations (e.g., child abuse, dependent adult abuse, psychiatric commitment) and represent the facility at legal hearings as requested.
• Ensure that documentation meets policies, procedures, standards, and laws.

Qualifications

• Bachelor’s degree in mental health/behavioral health or Social Sciences.
• Experience and willingness to provide services through telehealth.
• Two (2) years of experience in patient care and mental and behavioral health care or equivalent; demonstrated ability to function in a case management capacity including organizing and entering data, completing reporting, organizing patient files, communicating effectively through teleservices, and meeting licensing and accreditation standards.
• Knowledge of developmental tasks of children, adolescent, adult, and geriatric patients and the ability to apply this knowledge in assessment and planning of care.