Case Manager (Utilization Management)

UHS•Houston, TX

2d•Onsite

About The Position

Cypress Creek Hospital is a free-standing 128-bed, acute care psychiatric hospital located in north Houston, TX, and minutes south of The Woodlands. Cypress Creek Hospital features individual units for adolescents and adults and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 10,000 patients receive care from our compassionate health care team each year at Cypress Creek Hospital. We are comprised of a tenured dedicated team of Psychiatrists, Nurses, Social Workers, Mental Health Technicians and Support Staff where delivering compassionate care is our mission. To learn more about Cypress Creek Hospital visit our website at: www.cypresscreekhospital.com We currently have an opportunity for a Full Time Case Manager (Utilization Management). The Case Manager collaborates with physicians to effectively coordinate hospital, patient, and community resources to provide optimal care and secure appropriate reimbursement authorization for all parties. Hours are based on departmental, and facility needs and may include day, evening, and weekend hours, as directed by the Intake Director or CEO/Managing Director.

Requirements

Bachelor’s degree from an accredited college or university in social work, mental health, or a Nursing degree preferred.
Knowledge of behavioral health systems and Utilization Management required.
Minimum of two (2) years professional experience in a health care setting, preferably inpatient. Minimum of two (1) years’ experience in UR or Case Management.
LPC, LMSW, LVN or RN license preferred.
CPR and HWC Crisis Intervention training must be completed prior to beginning work (Can be obtained upon hire).

Nice To Haves

LPC, LMSW, LVN or RN license preferred.
Bachelor’s degree from an accredited college or university in social work, mental health, or a Nursing degree preferred.

Responsibilities

Follows patient through entire course of treatment acting as patient advocate, working to maximize cooperation between patient/patient family, treatment team and Managed Care Organizations.
Collaborates with all members of the Treatment Team, Business Office, and Admissions to ensure that patient needs are met first.
Ensures delivery of information to Business Office, Admissions Office, Managed Care Organizations, and the Director of Utilization Management, while monitoring quality of documentation to facilitate collections.
Communicates pertinent information internally in a timely manner and provide current certification status to treatment team and physician.
Demonstrates knowledge of referral sources.
Facilitates all patient transfers as needed.
Identify and assess available resources and communicate options to the physician, and treatment team.
Able to effectively serve and work with patients, families, MCOs, referral sources, community resources as well as departmental and facility co-workers and management team.
Interacts with patients in a professional manner using professional boundaries.
Interacts with facility guests in a professional manner promoting service excellence.