Full Time Insurance Case Manager Jobs (NOW HIRING)

• PRN position, Mondays and Fridays primarily needed.
• Job Summary The Case Manager is responsible for coordinating the hospital's Case Management for patients with the goal of providing effective discharge planning to reduce recidivism. Assesses, plans, implements, coordinates, monitors, and evaluates options to facilitate the continuum of care including pre-discharge planning with appreciate guardians or family member, follow-up appointments, housing, and transportation arrangements upon discharge. This person reports to the Director of Clinical Services, and can receive guidance from the Director of Social Services, or the Director of Risk Management and Compliance when necessary.
  • Access to daily admission report with purpose of effectively meeting new patients to coordinate discharge planning.
  • Meet with patients/contact patient guardian to complete required activities i.e. obtain collateral information regarding living arrangements, patient request and MD ordered activities.
  • Educates patients regarding effective allocation of community mental health resources while encouraging provision of high quality patient care.
  • Document appropriately gained legal authority to communicate with family members to gain collateral information through ROI.
  • Discuss alternative interventions needed for safe discharge to community.
  • Become aware of projected length of stay based on treatment team meetings.
  • Complete insurance bridges as appropriate and communicate with insurance case managers regarding updates, incidences, and discharge planning.
  • Attend Discharge and Treatment Team meetings and all meetings relative to case management/ court liaison functions.
  • Documents clearly and concisely all required documentation i.e. contacts and information of the patient's case management process on the appropriate chart forms.
  • Maintains current knowledge of case management/social services, discharge planning, and stay abreast of hospital programs and services provided.
  • Completes discharge and aftercare planning packages in advance of discharge date, typically 1-2 days prior to discharge, when discharge is projected.
  • Suggests and introduces new methods and techniques to leadership.
  • Develops and maintains therapeutic relationships with clients serving as a role model for clients by demonstrating positive, proactive, and respectful communications.
  • Communicate effectively with patients, parents, guardians, and staff of aftercare planning and expectations.
  • Performs other duties, as requested.
  • Upholds the Organization's ethics, values and customer service standards.

Requirements

• Education and/or Licensure - Bachelor's degree preferred - or high school diploma and a minimum of two (2) year's equivalent work experience required. Experience - Two years' experience in healthcare or healthcare-related case management duties - or one (1) year related experience in a psychiatric health care facility; direct practice in mental health treatment and experience in crisis intervention and customer service preferred.
• Additional Requirements - Bi-lingual English/Spanish preferred but not required.
• Knowledge Skills and Abilities Knowledgeable of patient rights and laws (i.e. EMTALA) pertaining to mental health and regulations pertaining to psychiatric nursing and the treatment of the mentally and emotionally disturbed patients. Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; Cultural sensitivity and demonstrated ability to work with diverse people groups. Basic knowledge of treatment procedures; interventions common to acute psychotic as well as non-violent crises intervention practice, medical, psychiatric emergency procedures and crisis intervention skills. Communicate effectively with a variety of individuals and function calmly in situations which require a high degree of sensitivity, tact, and diplomacy. Ability to exercise appropriate judgment in answering questions and releasing information in accordance with HIPAA and Personal Health Information Act requirements; analyze and project consequences of decisions and/or recommendations. Ability to handle confidential information with great sensitivity. Well-developed verbal and written communication skills in English. Skill to communicate effectively in order to exchange and/or provide information, build and/or maintain cooperative relationships. Skilled in problem solving, prioritizing and time management. Ability to document Case Management/Discharge plans in a clear and concise manner. Knowledge of state and federal programs and regulations that govern hospital discharge planning and those providing medical care and financial support to individuals, community resources. Ability to work on multiple tasks or parts of tasks simultaneously to ensure timely completion of work activities. Usually works forty (40) hours per week, including weekends. Must be able to multi-task, prioritize with strong time management skills. Exceptional follow through on tasks and assignments
• Physical Requirements/Environmental Conditions Perform the following with or without reasonable accommodations: Ability to stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, grasp, and be able to perceive the attributes of objects such as size, shape, temperature, and/or texture by touching with skin, particularly that of the fingertips. Ability to express and exchange ideas via spoken word during activities in which they must convey detail or important spoken instructions to others accurately, sometimes quickly and loudly. Hearing to perceive the nature of sound with no less than 40 db loss @ Hz, 1000 Hz, and 2000 Hz with or without correction; ability to perceive detailed information orally and make fine discriminations in sound. Perform repetitive motions with wrists, hands, and fingers. Individual must be able to exert up to 100 pounds of force occasionally and to be able to lift, carry, push, pull, or otherwise move objects. Work requires a minimum standard of visual acuity with or without correction that will enable people in the role to complete administrative and clerical tasks, as well as inspect and analyze. Must be able to work and concentrate amidst distractions such as noise, conversation and foot traffic; ability to handle interruptions often and be able to move from one task to another While worker may possibly be subjected to temperature changes, the worker is generally not substantially exposed to adverse environmental conditions as the work is predominantly inside.

Benefits

N/A, PRN status.