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