Psychiatric Case Manager

Lake Charles Memorial Hospital • Lake Charles, LA

5h

About The Position

The Psychiatric Case Manager supervises day to day functions of the department and staff. The manager actively seeks areas for department to improve (i.e - reduction in denials) &/ or be more efficient. SUPERVISION: Reports directly to Social Service Director RESPONSIBILITIES AND DUTIES: Prepares information for notification letters for providers and employees. Performs utilization review in accordance with all state mandated regulations. Maintains compliance with regulation changes affecting utilization management. Performs continuing review on medical records and identification and need of on-going hospitalization. Reviews patients' records and evaluates patient progress. Obtains and reviews necessary medical reports and subsequent treatment plan requests to conduct review. Reviews and validates physician's orders, reports progress and unusual occurrences on patients. Receives & processes requests for appeal of denials. Attends required meetings regarding approvals, denials, pre-certs, authorizations and retro reviews. The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description. EDUCATION AND WORK EXPERIENCE BA required, Social Work preferred OR Nursing Certification with RN preferred Minimal 3-5 Years Experience working with mentally ill &/or addictions required Louisiana Nursing License or multi-state compact nursing license preferred, Crisis Response Training, CPR Knowledge of mental health diagnoses, treatment options, and community resources. Strong communication and interpersonal skills. Ability to work effectively with individuals from diverse backgrounds. Shows ability to gain and maintain support and respect. Physical Demands/Work Environment Work requires a variety of physical activities including sitting, standing and walking. Bending, stooping, and lifting are minimal. The work environment may be physically confining. Visual acuity required for a variety of activities. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Experience Memorial is more than a slogan, its the care we provide our patients and its the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated. Working at Lake Charles Memorial Health System | Great Place To Work

Requirements

• BA required, Social Work preferred OR Nursing Certification with RN preferred
• Minimal 3-5 Years Experience working with mentally ill &/or addictions required
• Louisiana Nursing License or multi-state compact nursing license preferred
• Crisis Response Training
• CPR
• Knowledge of mental health diagnoses, treatment options, and community resources.
• Strong communication and interpersonal skills.
• Ability to work effectively with individuals from diverse backgrounds.
• Shows ability to gain and maintain support and respect.

Responsibilities

• Prepares information for notification letters for providers and employees.
• Performs utilization review in accordance with all state mandated regulations.
• Maintains compliance with regulation changes affecting utilization management.
• Performs continuing review on medical records and identification and need of on-going hospitalization.
• Reviews patients' records and evaluates patient progress.
• Obtains and reviews necessary medical reports and subsequent treatment plan requests to conduct review.
• Reviews and validates physician's orders, reports progress and unusual occurrences on patients.
• Receives & processes requests for appeal of denials.
• Attends required meetings regarding approvals, denials, pre-certs, authorizations and retro reviews.

What This Job Offers

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