Case Manager

Company: Live Oak Mental Health and Wel
Location: North Charleston
Posted on: March 18, 2023

Job Description:

Job Description:

Description Introduction Do you have the career opportunities as a(an) Case Manager you want with your current employer? We have an exciting opportunity for you to join which is part of the nation's leading provider of healthcare services, HCA Healthcare.Benefits HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Fertility and family building benefits through Progyny Free counseling services and resources for emotional, physical and financial wellbeing Family support, including adoption assistance, child and elder care resources and consumer discounts 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan Retirement readiness and rollover services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Case Manager where your passion for creating positive patient interactions are valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!Job Summary and Qualifications Position Summary The Case Manager coordinates the day to day operations of the Behavioral Health Support Services under the direction of the Manager of Behavioral Health while coordinating all Social Work functions on the Inpatient and Outpatient Units. Carries out all responsibilities in accordance with the organization's core values, applicable policies, procedures, and civil laws, the Corporate Responsibility Program. The role of the Case Manager is to facilitate optimum patient outcomes through a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs, using communication and available resources to promote quality and cost-effective outcomes through a full continuum of care. The Case Manager identifies opportunities for improvements in patient care. The Case Manager provides documentation of all functions as required by regulatory agencies. To work closely with all managed care insurance companies, MCD, MCR or other agencies as needed as well as DMH, Business Office, Benefits, and Admitting Office in obtaining authorization and certification of days for inpatient stays. To keep a log of all such activities, showing number of certified days and other information as needed and enter authorization number into Meditech and Midas. The Case Manager will communicate with Physician/Nurses/Therapists when more information or documentation is needed to receive certification. To inform Behavioral Health Nurses/Therapists when clinical information is needed to be entered into the Meditech/Midas System for reviews that need to be called into insurance companies. To communicate as required by contract with managed care companies either by fax or phone and to log communication. To work closely with the Business Office in preventing or reversing any possible denial. To retrieve any documentation to show IS/SI of service when denial is received. To forward such documentation to the parties submitting the denial and request a revision if indicated. To log information concerning the denial. To work with the Case Manager of Day Surgery (ECT) in obtaining authorization and certification for Day Surgery (ECT) patients that require observation or inpatient status. To identify inappropriate or untimely service that could result in a denial, partial denial or avoidable day. To relay this information to the Behavioral Health Director. To identify opportunities for improvements of untimely service that could result in a denial, partial denial or avoidable day. Major Responsibilities: Quality - In participation with the Inpatient and Outpatient Managers, develop and maintain operating policies and procedures for BHSS. - Ensure efficient and appropriate operations in the BHSS, including the appropriate triage of calls and handling of insurance information. - Intake sheets, patient charts, and records are reviewed regularly to ensure accuracy and completeness of documentation. - Coordinates with the Managers and Director to ensure optimal functioning support services. - Assists and perform as Discharge Planner - The BHSS Case Manager collects data about patients and identifies individual needs to develop comprehensive cost-effective discharge plan post-hospitalization needs of patients of all ages, making necessary arrangements to assure continuity of care. - Performs an admission review and discharge assessment within 24 hours of admission of first working day and identifies patients who are at risk for discharge planning barriers and/or who have potential for extended lengths of stay - Provides ongoing assessment of medical necessity using established criteria. This position requires a thorough knowledge of state and federal regulations regarding medical necessity for admission and discharge screens. - Assures ongoing communication through documentation and re-assessment of the patient and discharge plan considering the anticipated needs at the present and future levels of care. - Receives referral from physicians, patient/family, or any member of the multidisciplinary team. The case management segment of the Nursing Admission Assessment is one method by which patients who may need assistance after discharge are identified and referred. - Provides education about community resource for patients and families to support realistic choices about post-hospital care plans and to facilitate the implementation of the plan in conjunction, as appropriate, with the payer source. The BHSS Case Manager maintains current knowledge of community resources, discharge planning and referral to nursing homes, extended care and rehabilitation facilities. - Provides for professional growth and development within the department - On assigned projects or committees, gives input and direction to promote the programs - Skills, knowledge and experience in areas of job responsibilities are enhanced through attendance at workshops and seminars. - Encourages and facilitates staff development for optimal patient care practices. - Ongoing learning needs assessment is used to identify and plan appropriate staff development programs with the department of Education and both Behavioral Health managers. - Effective learning experiences are facilitated for unit staff in the clinical setting - Serves as a role model for unit staff through expert knowledge and application of the nursing process and critical thinking skills. - Demonstrates the ability to incorporate age specific concepts for population being served as identified in the units Scope of Care and criteria for provision of age related care. - Collection and interpretation of data including Assessment & Evaluation; and Assignment of appropriate treatment Levels of Care. Service - Promotes consistent, positive patient interactions that advance the agenda of unparalleled patient service. - Demonstrates caring and empathy in all interactions and advocates for patient- and family-centered approach in all decisions and actions. - Demonstrates excellent communication skills, including active listening. Ensures patients, physicians, and colleagues have a clear understanding of all communications. - Engages in evidence-based best practices that enhance the patient experience, including communication fundamentals/AIDET, Teach-Back, Narrating Care, etc. - Participates as an active member of the health care team and positively promotes the rest of the team to patients/families/caregivers and other colleagues. - Maintains a professional appearance and demonstrates behaviors consistent with established policies/procedures. People - Serves as a resource to department staff, students, volunteers and other departments, and contributes to the teamwork essential to ensuring quality patient care. - Assists in the orientation of new staff as needed. Growth - Participates in hospital or departmental performance improvement activities, and seeks opportunities to improve department and inter-department processes. Other - Performs other duties as assigned. - Practices and adheres to the "Code of Conduct" and "Mission and Value Statement." What qualifications you will need: --- 1+ years of experience in a healthcare setting Preferred --- Bachelor's Degree Required --- Master's Degree Preferred Licensure, Certifications, Training: Credential*: Required: Preferred: Grace Period (select if applicable): BLS --' --- Nonviolent Crisis Intervention --' --- 90 Days LISW/LPC/RN --- --' This role requires you to be fully vaccinated for COVID-19 based on local, state and /or federal law or regulations (unless a medical or religious exemption is approved). Live Oak Mental Health and Wellness Center, is a part of Trident Health. We give inpatient stabilization treatment to patients who seek treatment for acute psychiatric symptoms which cannot be addressed on an outpatient basis. Common disorders of patients treated in this program include but are not limited to: major depressive disorder, schizoaffective disorder, schizophrenia, bipolar disorder, adjustment disorders, post-traumatic stress disorder, impulse control disorder and a variety of co-morbid personality disorders. Our patient population is both adult and adolescent. We offer 24 hour availability of a full range of services. We have the capability to institute rapid lifesaving interventions. Our physician availability is 24 hours a day to institute needed modification to the treatment plan. Psychiatrist involved in the direction and management of the treatment program. Round the clock skilled nursing care implementing the treatment plan and providing monitoring and assessment of the patient's condition and response to treatment. \n\n HCA Healthcare has been recognized as one of the World's Most Ethical Companies - by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Case Manager opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today! We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Keywords: Live Oak Mental Health and Wel, Charleston , Case Manager, Executive , North Charleston, South Carolina