Department: Social Services
Job Code: 7-400
The Case Manager coordinates with the admission staff and clinical staff to facilitate the meeting of patient's treatment needs as well as management of utilization review activities for the inpatient programs in accordance with the Joint Commission, Federal and State regulations, Oceans' mission, policies and procedures and PI standards. Acts as patient liaison for physician, clinical staff and family member's activities. Works in coordination with the PI Coordinator to conducts closed and concurrent reviews of medical records. Interacts with members of the medical/clinical team to provide a flow of communication, ensure criteria for admission and continued stay are met and that the medical record documentation supports the level and intensity of service rendered as well as facilitating timely discharge planning. Works with the primary therapist and nursing staff to facilitate treatment planning documentation, family contact, scheduling appointments, absentees from programming and access to community resources.
Associate's Degree with emphasis on healthcare or Bachelor's degree in social services field preferred. At least one year psychiatric/chemical dependency experience with good working psychiatric/medical knowledge.
SKILLS AND KNOWLEDGE:
Must have excellent assertive communication skills. Knowledge and in-depth understanding of CD/psych treatment and discharge planning process. Must have good writing and composition skills. Must have good understanding of regulatory and fiscal reimbursement and utilization review as a primary component of patient care. Must demonstrate strong patient advocacy skills. Must be able to organize and prioritize high volume workload. Must be able to analyze and utilize data and systems to provide individualized quality treatment in a cost-effective manner. Must be able to function with minimal supervision. Therapeutic Intervention De-escalation Eduction required. Must have ability to maintain overall good work attitude and interact cooperatively and professionally with other staff members and third party payers to achieve mutually beneficial outcome. Must possess basic competency in age/disability/cultural diversity needs of patients served and ability to relate to patients in a manner sensitive to those needs.
Shall be able to maintain CEU requirements, CPI and CPR certifications and complete other educational requests as assigned and/or needed to increase skill level.