Case Manager

Pyramid Healthcare•Joppa, MD

11d•Onsite

About The Position

Pyramid Healthcare is dedicated to offering the highest quality of care to those we serve. Our focus on client-centered care establishes our family of brands as respected leaders in addiction treatment, mental health recovery, and eating disorder treatment modalities. Under passionate leadership, we provide comprehensive behavioral healthcare defined by supportive environments that empower patients to overcome life’s challenges. We offer a full spectrum of behavioral healthcare services—psychiatry, addiction recovery, mental disorder treatment, and more—allowing clients at all stages of recovery to reclaim their health and well-being.

Requirements

High school diploma or equivalent required.
Minimum of 2-3 years of experience in a healthcare setting.
Excellent interpersonal communication skills and knowledge of community and statewide referral options.
Demonstrates professionalism, leadership, confidentiality, and strong social communication skills.
Possesses effective communication skills and interacts well with people from diverse backgrounds.
Exhibits excellent oral and written communication abilities.
Capable of problem-solving by gathering and analyzing information, both individually and in group settings.
Maintains professionalism and consistency, avoiding favoritism with clients, staff, visitors, and the public.
Ability to handle crisis situations calmly and decisively.
Demonstrates flexibility and adaptability in decision-making, maintaining objectivity and ethical standards.
Sustains a team environment, drives continuous improvement projects, and maintains confidentiality.

Responsibilities

Ensure clients with substance use and addiction issues have access to a full continuum of care by identifying and assessing their needs.
Coordinate appointments, aftercare plans, schedules, and meetings.
Monitor for delays in providing supportive services using Medicare/Medicaid DRG length-of-stay as a guideline.
Conduct ongoing reviews throughout the patient’s stay to ensure medical necessity and appropriate treatment levels.
Collect quality data related to denial management, avoidable days, length of stay, outliers, admits, and readmissions.
Maintain positive relationships with referral sources and insurance companies.
Organize reporting systems for counselors regarding due PCPCs and necessary review calls.
Accurately maintain daily ECR database and ensure proper documentation in patient charts.
Investigate cases with insurances and referral sources to recover any lost funding days.
Make referrals to Mental Health and Drug and Alcohol facilities for continuing care.
Facilitate Halfway House interviews and placements.
Provide direct care to adults with chemical dependency issues in the 3C program, ensuring their safety and well-being.
Participate in the implementation of client treatment by maintaining communication with clients, family members, and counselors.
Schedule family therapy appointments and coordinate the treatment planning process to ensure adherence to Treatment Team recommendations.