Case Manager, BHU

HENRY MAYO NEWHALL MEMORIAL HOSPITAL • Santa Clarita, CA

1d • Onsite

About The Position

The Behavioral Health case manager is responsible for case management across the continuum of care, utilizing an interdisciplinary approach to manage patient throughput in a fiscally responsible manner to achieve optimal outcomes. This role involves the coordination of care, utilization review, and acting as a resource for patients, families, significant others, and staff. The case manager will make referrals to clinical social workers for psycho-social issues and complicated discharge planning. Key responsibilities also include overseeing the coordination of post-hospital care needs and interacting with insurance companies, medical groups, and community resources to ensure timely and efficient use of all services. The position requires applying knowledge of the expected clinical process, available resources, medical necessity criteria, regulatory requirements, and relevant standards of care to anticipate patient needs.

Requirements

• Current ASW, AMFT license
• Current BLS provider card
• Masters degree SW or MFT OR Diploma RN or BSN degree
• Two years as a Case Manager in an acute care setting OR five years recent acute care nursing experience
• Strong interpersonal skills
• Leadership skills
• Negotiation skills
• Good leadership talent
• Knowledge of hospital operations
• General knowledge of the payer industry, resource management, reimbursement, and evidence-based clinical practice
• Ability to develop, maintain, and model professional, objective and value-oriented interpersonal skills
• Ability to continuously promote a patient-centered philosophy
• Ability to maintain positive and proactive communication with patients, families, staff members, and physicians
• Ability to foster team-building relationships
• Excellent organizational skills
• Ability to problem solve

Responsibilities

• Case management across the continuum of care utilizing an interdisciplinary approach to managing patient throughput in a fiscally responsible manner to achieve optimal outcomes
• Coordination of care
• Utilization review
• Acting as a resource to patients, family and/or significant others and staff
• Referrals to clinical social worker for psycho-social issues and complicated discharge planning issues
• Overseeing coordination of post-hospital care needs
• Interacting with insurance companies, medical groups, and community resources to ensure timely, efficient use of all services
• Applying knowledge of the expected clinical process, available resources, medical necessity criteria, regulatory requirements, and relevant standards of care in anticipating patient needs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees