Job Details

Job Description:

Summary:
Responsible for coordinating services necessary to maximize patient outcomes and quality care, ensuring efficient movement of the patient through the continuum of care and minimizing unnecessary utilization. Must have exceptional behavioral health clinical assessment and intervention skills in order to oversee the care of this population. Must anticipate, plan and discuss patient needs with the patient, family, physician, members of the interdisciplinary team, external providers and third party payors. Collaborate with team members in order to minimize delays in care delivery, identify barriers to care, and ensure positive outcomes.

Responsibilities include communication and collaboration with payor sources, achieving precertification and ongoing concurrent certification to ensure payment appropriately for services provided. Must have an in-depth knowledge and ability to apply various payor's rules and regulation, admission, discharge, and continued stay reimbursement criteria and both Interqual and Milliman and Robertson Care Guidelines. Must monitor resource management and cost effectiveness of care for the population. Ensuring patient safety and achieving positive clinical outcomes will always be the ultimate guiding force in the position.

Participate as a member of the clinical treatment team. Including:
1. Ability to perform psychosocial assessments.
2. Participate in treatment planning and facilitate treatment team meetings
with therapists, nurses, and physicians.
3. Coordinate discharge planning including referrals to outpatient providers,
nursing home and assisted living placements, case management referrals,
home health care, and medical practitioners. Must have a good knowledge of
the continuum of care including services available for mental
health/addictions referrals i.e.; psychiatric group homes, residential
treatment facilities, and other specialized services.
4. Participate in inpatient programming, as needed, including providing
individual and group education for patients and families.
5. Advising, education, advocating for and facilitating access to needed
resources.
6. Be able to respond to the needs of special populations such as the
homeless, substance abuser, and families with complex social situations.

Requirements:
1.) Baccalaureate degree in nursing, social work, or psychology other related field.
2.) 2 years of clinical experience in the field of psychiatry, mental health,
addictions, behavioral health care, or case management preferred.
3.) Excellent management communication, problem solving, decision making and
critical thinking skills.

Licenses and Certifications:
If degree is in nursing, must be a graduate of an accredited school and hold required licensure from the appropriate state.
National certification in case management encouraged.

Work Requirements:
Shift: Day
On Call: No
Weekends: No
Travel Required: No Travel

Location:
Ballad Health Corporate