Case Manager, Bhu

Job Summary:

The Behavioral Health Case Manager is responsible for case management across the continuum of care utilizing an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes. Also responsible for the coordination of care, utilization review, acting as a resource to patients, family and/or significant others and staff; referrals to clinical social worker for psycho-social issues and complicated discharge planning issues; overseeing coordination of post-hospital care needs; interacting with insurance companies, medical groups, and community resources to ensure timely, efficient use of all services. Applies knowledge of the expected clinical process, available resources, medical necessity criteria, regulatory requirements, and relevant standards of care in anticipating patient needs.

Licensure and Certification:

• Current ASW, AMFT license
• Current BLS provider card

Education:

• Mastersdegree SW or MFT
• Diploma RN or BSN degree

Experience:

• Two years as a Case Manager in an acute care setting or five years recent acute care nursing experience.
• Strong interpersonal skills, leadership, negotiation skills, good leadership talent, and knowledge of hospital operations. General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice is essential.

Knowledge and Skills:

• Develops, maintains, and models professional, objective and value-oriented interpersonal skills. Continuously promotes a patient-centered philosophy.
• Maintains positive and proactive communication with patients, families, staff members, and physicians.
• Fosters team-building relationships. Excellent organizational skills and the ability to problem solve are essential.

Physical Demands - Clerical/Administrative Patient Care:

• Frequent sitting and standing/walking with frequent position change.
• Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
• Occasional/intermittent reaching at or above shoulder level.
• Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.
• Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
• Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.