Intake Case Manager - Social Work Services

Landmark Medical Center•Woonsocket, RI

59d

About The Position

The Intake Case Manager (ICM) initiates triage for patients presenting to the Emergency Department in psychiatric emergency crisis and is responsible for the quality of emergency triage and appropriate resource management for patients requiring emergent psychiatric assessment, triage, disposition, or crisis management. The ICM assesses psychiatric patients presenting to the Emergency Department or an acute care unit and ensures appropriate admission or disposition for patients with potential psychiatric illness. The role ensures regulatory standards for psychiatric admission are met, coordinates with the attending psychiatrist regarding admission orders, and works with community resources on disposition when the facility cannot meet a patient’s care needs. The ICM conducts utilization review related to triage and Behavioral Health Unit admissions, including comprehensive admission and concurrent medical-record review for medical necessity, intensity of services, and severity of illness. As a patient advocate, the ICM promotes cost containment and provides leadership in coordinating health care providers for seamless care across the continuum. The role supports quality, clinical and cost-effectiveness, evidence-based practices, interdisciplinary team members, and the discharge-planning process throughout the patient’s admission.

Requirements

Maintain an active Rhode Island license as a Registered Nurse, LCSW, or LICSW.
At least 5 years of psychiatric experience.
Knowledge of psychiatric medical necessity, case management regulations, and discharge planning.

Nice To Haves

More than 2 years of management experience.
Experience in psychiatric emergency and triage.
Knowledge of Milliman Criteria and InterQual Criteria.

Responsibilities

Initiate triage for patients presenting to the Emergency Department in psychiatric emergency crisis.
Maintain the quality of emergency triage and manage resources appropriately for patients needing emergent psychiatric assessment, triage, disposition, or crisis management.
Assess psychiatric patients presenting to the Emergency Department or any acute care unit.
Ensure appropriate admission or disposition for patients presenting with potential psychiatric illness.
Ensure regulatory standards related to psychiatric admission are met.
Coordinate with the attending psychiatrist to obtain appropriate admission orders.
Coordinate with community resources for disposition when the facility cannot meet a patient’s care needs.
Conduct utilization review related to triage and admission to the Behavioral Health Unit.
Review medical records comprehensively at admission and concurrently for medical necessity, intensity of services, and severity of illness.
Advocate for patients, promote cost containment, and demonstrate leadership in integrating health care providers across the care continuum.
Provide oversight throughout the patient admission and support interdisciplinary team members and discharge planning.