Integrated Case Manager

The Recovery Village•Groveport, OH

2d•Onsite

About The Position

The Integrated Case Manager (ICM) provides comprehensive, patient-centered services throughout the patient's treatment episode. The role integrates financial counseling, insurance and patient financial responsibility, discharge planning, aftercare coordination, employment and leave-related support, resource coordination, and continuity-of-care activities. Each ICM owns the complete integrated case management workflow for assigned patients, identifying, addressing, documenting, and following through on needs within the position's scope. The ICM coordinates financial and insurance matters, develops and updates individualized Case Management Discharge Plans, plans for discharge and aftercare, coordinates leave-related requests, and works with internal departments and external providers to address barriers to treatment and continuity of care. The position also participates in treatment-team and operational meetings, maintains accurate records in approved systems, supports patient de-escalation within approved techniques, and follows confidentiality and compliance requirements.

Requirements

Minimum high school diploma.
Two years of clinical experience in the medical and/or behavioral healthcare field.

Nice To Haves

Bachelor’s degree in a health-related field preferred.

Responsibilities

Meet with assigned patients within established timeframes, complete initial contact, and manage the integrated case management workflow throughout treatment.
Complete case management and discharge-needs assessments; identify financial, insurance, discharge, aftercare, employment, legal, and other barriers; create an individualized Case Management Discharge Plan (CMDP); and review and update it at least weekly or when needs change.
Educate patients and responsible parties about insurance benefits, patient financial responsibility, billing expectations, and payment options.
Review and validate insurance coverage and patient financial responsibility using approved systems, payer portals, Revenue Cycle resources, and direct payer communication as needed.
Monitor coverage during treatment and address coverage changes, lapses, coordination-of-benefits issues, and financial barriers that may affect treatment or continuity of care.
Collect applicable private-pay fees, copays, deductibles, and other patient responsibility, and establish approved payment arrangements in accordance with organizational policy.
Document financial information and communications accurately and promptly in Avatar, including CEFE information, guarantor order, collections, payments, payment arrangements, and financial counseling.
Conduct discharge and aftercare planning; review plans with patients; coordinate warm handoffs; confirm follow-up appointments before discharge when applicable; obtain patient feedback; and document final plans in Avatar.
Coordinate services and follow-up with behavioral health, substance use disorder, medical, psychiatric, MAT, outpatient, and other providers as appropriate.
Collaborate with Business Development, referents, payors, outpatient services, and community providers, documenting communications in approved systems such as Avatar and Salesforce as applicable.
Coordinate administrative components of FMLA, short-term disability, state-paid leave, and return-to-work requests, including intake, tracking, patient communication, non-medical sections, and timely routing.
Coordinate medical certification and clinical documentation with the Patient Services Coordinator and appropriate provider; do not complete medical sections outside the position's scope.
Ensure aftercare plans, CMDP documentation, discharge folders, referrals, appointments, required letters, and patient resources are complete, accurate, and patient-ready.
Participate in treatment-team meetings and communicate relevant financial, discharge, aftercare, and patient-barrier information to support treatment planning and continuity of care.
Coordinate with other Integrated Case Managers regarding treatment-team attendance, patient intakes, workload distribution, coverage, daily huddles, and handoffs.
Collaborate with Revenue Cycle Management, Admissions, Utilization Review, Clinical Leadership, and other departments to resolve financial, insurance, discharge, or continuity-of-care barriers.
Meet integrated performance expectations for patient contact, CMDP follow-up, financial counseling and collections, leave-related requests, appointment coordination, warm handoffs, aftercare completion, and timely documentation; proactively address outstanding needs.
Escalate significant financial, coverage, discharge, documentation, patient-care, or workflow barriers to appropriate leadership when they fall outside the role's scope.
Maintain competency through required education, cross-training, and ongoing professional development.
Develop and maintain proficiency in Heather AI and other approved documentation systems, ensuring accurate and timely electronic medical record entry.
Support patient de-escalation using approved techniques and maintain professional boundaries.
Communicate significant patient developments, risks, barriers, and operational concerns to the appropriate supervisor or treatment-team member in a timely manner.
Attend required treatment-team, case-management, operational, and individual check-in meetings.
Accept and incorporate supervisory feedback and adapt to changing workflow, patient, and site needs.
Track and support quality and performance expectations established by leadership.
Maintain confidentiality and comply with HIPAA, state, federal, accreditation, and organizational requirements.
Perform other duties assigned to support patient care and organizational operations.

Benefits

Benefits begin on the first day of the month following the date of hire.
Pay of $23–$25 per hour, based on experience.
Vacation: two weeks in year one, increasing with tenure.
Seven paid holidays per year.
Paid sick leave accrued at one hour for every 40 hours worked, consistent with Washington law.
401(k) with a company match of 50% on the first 4% of eligible pay.
Health, vision, dental, and life insurance.
Telemedicine access and visits at no cost to the employee.
Health Savings Account with a company contribution of up to $1,500 per year.
Employee referral bonus of up to $4,000.
Travel Concierge, LifeMart employee discounts, Health Advocate, and EAP.