Case Manager

UHS • Tequesta, FL

2d

About The Position

SandyPines Residential Treatment Center is a 149-bed Residential Psychiatric Facility servicing children and adolescents ages 5 to 17. The facility is in beautiful South Florida, nestled beside Jonathan Dickinson State Park and just minutes away from the shores of the Atlantic Ocean. We are the largest treatment center of its kind in the southeast and host Riverbend Academy, an accredited school on our campus.
Much more online at: sandypineshospital.com
The UR/Case Manager performs concurrent reviews with insurance companies for continued stay for residents. Assures optimum quality of patient care in the most cost-effective manner. Works closely with both Utilization Review and Social Service's Department to ensure quality of patient care.

Requirements

• Education: Bachelor’s degree in Psychology, Mental Health Counseling, Social Work, Nursing or any related field required.
• Minimum of 2 years of experience needed working in a psychiatric or substance abuse setting: 3-5 years of experience in case management and/or utilization review in the psychiatric field preferred.
• License/Certification: Not required.
• Skills: Good oral and written communication skills required to communicate in a clear and concise manner with patients, physicians, staff and administration. Stable emotional makeup required to work in a fast paced environment with frequent interruptions
• Physical Requirements: Work is sedentary requiring sitting most of the day. Sitting at least six hours a day while processing paperwork, and answering phones. Lifting up to 20 pounds of copier paper from floor level to check level while filling copier paper

Nice To Haves

• 3-5 years of experience in case management and/or utilization review in the psychiatric field preferred.

Responsibilities

• Performs concurrent reviews on a daily basis
• Performs case management duties, i.e. referrals for aftercare services, collaborates with all parties of the treatment team
• Ensures discharge planning is completed for all residents
• Liaison between treatment team, referral source, community agencies, court officials, outside therapists; maintains the integrity of the medical record of assigned residents; leads specific treatment team meetings
• Maintains records of the review process, following the facility UR Plan
• Communicates any concurrent review complications to Administration
• Performs current case review complications with insurance companies as scheduled
• Initiates denial letters as indicated by the facility UR Plan
• Informs attending physicians at any time during stay if there are complications with continued stay
• Ensure appropriate parties are notified in event of continued stay denial
• Appeals all denials within allotted timeframe
• Maintains accurate logs and record

Benefits

• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level