Behavioral Health Case Manager (RN)

Children's Healthcare of Atlanta

2d•Onsite

About The Position

Provides clinically and evidence-based patient care coordination for patients with behavioral and mental health (BMH) needs. Supports delivery of safe, effective, high-quality, and efficient patient care at Children’s Healthcare of Atlanta. Coordinates assessment, interdisciplinary discharge planning, and coordination of community-based services to assigned patients discharged from a Children's Healthcare of Atlanta facility. This will focus on case management duties for Behavioral Mental Health/Neuropsychiatry patients.

Requirements

3 years RN experience with a Bachelor of Science in Nursing (BSN)
OR a current Children’s nurse with 5 years/7,500 hours of experience with an Associate’s degree in nursing (Current Children’s nurse with an associate’s degree in nursing is required to obtain a BSN within 2.5 years of hire date)
3 years of broad clinical experience, predominantly in pediatric or behavioral and mental health care
Graduation from an accredited school of nursing
Licensure as a Registered Nurse in the single State of Georgia or Multi-State through the Enhanced Nurse Licensure Compact
Basic Life Support (BLS) within 30 days of employment
Registered Nurse case management certification from approved accrediting organization within 1 year of meeting eligibility requirements
Excellent communication skills, both verbal and written
Effective decision making/problem-solving skills and demonstration of creativity in problem-solving
Influential leadership skills
Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs
Moderate to expert computer skills
Working knowledge of financial aspects of third-party payors and reimbursement

Nice To Haves

Master's degree
Previous Mental Health experience, pediatric or adult
EPIC experience
Experience in care coordination, case management, discharge planning, and utilization review

Responsibilities

Serves as a system clinical resource for Care Coordination Assistants during scheduled shift.
Completes initial screen of all patients on admission (not to exceed within 24 hours of admission) utilizing specific trigger criteria to identify needs related to care coordination and/or discharge planning.
Develops, initiates, and implements a robust transition care plan in collaboration with clinical team for all applicable patients.
Cultivates and maintains effective interaction/communication with providers, nursing staff, social workers/counselors and others to drive care coordination process and facilitate continuity of patient care.
Communicates with all members of multidisciplinary team to facilitate care coordination process for assigned workload.
Oversees psychiatric residential treatment facility (PRTF) referral process, documentation, and submission, as necessary.
Communicates with home health agencies, third-party payors, acute and long-term psychiatric facilities, and other community resources as needed to coordinate discharge needs.
Ensures information sharing with Community Care Navigators regarding any BMH patients who require PRTF, meet high-utilizer criteria, or are identified as complex.
Facilitates and provides ongoing communication with patient/family and interdisciplinary staff to identify, escalate, and resolve potential barriers.
Facilitates care conferences, interdisciplinary rounds, and other meetings.
Serves as the clinical tiered support for EMS transport needs and escalations.
Completes medication prior authorizations and prescription arrangements, as necessary.
Participates in focused system initiatives and facilitates clinical practice guidelines at the patient level.
Performs outpatient and clinic care coordination and monitors care as patients transition between outpatient and inpatient services where appropriate.
Refers cases identified as risk management, peer review, or quality issues to appropriate personnel.
Performs other responsibilities as required.