Case Management Coordinator

East Tennessee Behavioral HealthKnoxville, TN

About The Position

The Case Management Coordinator assesses, plans, implements, coordinates, monitors, and evaluates services to meet an individual’s needs during treatment. This role involves managing client/patient/resident cases through the development and implementation of individual care plans, collecting clinical data, and staying informed through continuous review of documentation. The coordinator also tracks, monitors, and reports on inpatient or outpatient care, conveys medical criteria and clinical information between insurance providers and the treatment team, and conducts precertification with third-party payers.

Requirements

  • Bachelor’s degree in Health Administration, Social Science or a related field or relevant previous job experience required.
  • Ability to create and maintain professional liaison with community agencies and organizations to ensure continuity of care.
  • CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).
  • First aid may be required based on state or facility.

Nice To Haves

  • Knowledge of mental health and substance use fields is preferred.

Responsibilities

  • Assure residents meet criteria for admission, and review initial clinical information through discharge.
  • Monitor and manage client/patient/resident’s cases through development and implementation of individual care plans, collecting clinical data and remain informed by continuous review of documentation.
  • Coordinate care by tracking, monitoring, and reporting on inpatient or outpatient care.
  • Manage client/patient/resident’s cases with knowledge and expertise with the patient population of the facility.
  • Convey medical criteria and clinical information between the client/patient/residents’ insurance provider and treatment team as warranted and may also provide this information to the business office, as needed.
  • Conduct precertification with third party payers and negotiate approved days with the provider for the patient/resident admission.
  • Assigned tasks for admission review, concurrent review and participate in discharge planning.
  • Perform other functions and tasks as assigned.
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