Case Manager

Description Job Purpose This position is responsible for supporting the unit by obtaining and reviewing insurance verification/pre-certification/certification and navigating the appropriate access system for patient care and outcome.

Responsibilities

Provides assessments, treatments, and case management to patients and families. Responsible for any insurance verification/certification needed. Responsible for completing the necessary application for any patient in need and following up on the appropriate process until completion. Participates in discharge planning, arranges for follow-up care, and develops mechanisms for the exchange of appropriate information with sources outside the hospital. Initiates pre-certification and re-certification of insurance on all registered patients requiring it. Serves as a resource person to healthcare professionals concerning psycho-social problems and community resources. Educates the patient and families on signs and symptoms of illness to prevent re-hospitalization and improve disease management skills. Maintains performance improvement activities within the department and participates in performance improvement activities.

Requirements

Bachelor’s Degree, or higher, in Social Work or Nursing License required Two or more years of previous experience in all aspects of social service or nursing with an emphasis in psychiatric work. BLS CPI training will be provided Basic computer knowledge Strong interpersonal skills Working conditions In clinical duties, will have the potential to be exposed to communicable diseases, blood, and body fluids. Exposure to injury from patients or equipment. Realizing there are unavoidable environmental hazards, the employee must assume responsibility for knowledge of protocols and policies relevant to these hazards. Utilized appropriate protective attire that will be provided in each area.

• Physical requirements Ability to handle heavy materials or patients.
• Physical demands greater than moderate may require knowledge of the use of appropriate equipment.
• Frequent bending, lifting, and pulling require proper use of good body mechanics.
• Must be able to communicate effectively with patients, staff physicians, and visitors, displaying a smile and maintaining a pleasant attitude.
• This job includes close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
• Also, the ability to communicate by phone is important.

Direct reports This position has no direct reports.