CASE MANAGER

Description

BASIC PURPOSE:

Works in conjunction with patients, patient families, physicians, nursing and other health care professionals to assist with the needs of patients provided services by our organization in compliance with the established policy and procedures. This position will be responsible for handling crisis that arise for patients daily and interfacing between the patients, families and providers within the department. Duties will include the responsibility for screening internal and external referrals and making appropriate
placement of patients given the needs of the patients. Other duties include data collection, entry, and
monitoring a patients progress throughout the many levels of care in this facility. The case manager must
be knowledgeable and able to access different outpatient and community support systems to grant
patients access to different types of services, ie patient assistance programs, Medicaid, and welfare
services. This position requires the ability to be able to work closely with patients, families, physicians,
psychologists, social workers and other members of the treatment team to develop individual and
departmental treatment goals. Must be knowledgeable and able to access many different types of
services. Assesses and treat individuals with behavioral health and mental illnesses

Promotes Organizational Excellence and our corporate values of INTEGRITY, COMPASSION, EXCELLENCE, COMMITMENT and COMMUNITY

ESSENTIAL FUNCTIONS FOR CASE MANAGER
This description does not state or imply that the duties, essential functions, and job requirements are the ONLY parameters for this position. Associates are required to follow job related instruction and perform other job related activities requested by their supervisor.

All requirements are subject to possible modification in order to provide a reasonable accommodation to individual with physical or mental disabilities as defined by the Americans with Disabilities Act. Some requirements may exclude individuals who pose a direct threat or significant to the health and safety of themselves, the patients or other associates.

PHYSICAL REQUIREMENTS:
1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in performing nursing duties throughout the work shift.
2. Must be able to read and write legibly in English.
3. Must be able to type.
4. Must be able to exert up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently and/or negligible amount of force constantly to move objects.
5. Hearing within normal range is required.
6. Visual acuity must be within normal range.
7. Must be able to sit for extended periods reading charts, files, etc.
MENTAL REQUIREMENTS:
1. Must be able to handle and maintain confidential information.
2. Must have the ability to perform concentrated and complex mental activity with frequent involvement in complex and highly technical situations.
3. Must have the ability to work successfully under highly stressful conditions, and must be capable of adapting to varying workloads and work assignments on a constant basis.
4. Must have the ability to make sound, independent judgments based on scientific principles, and also be able to collaborate with other multi-disciplinary team members in an appropriate fashion.
5. Must have the ability to comprehend and perform oral and written instructions and procedures.
6. Must have effective reading and comprehension skills.
7. Must have strong verbal and written communication skills.
8. Must have math skills to work with statistics, data collections, etc.
9. Must be able to organize, prioritize and complete assigned tasks.
10. Must be able to work flexible and/or extended hours.
ENVIRONMENTAL CONDITIONS (POTENTIAL FOR) :
1. Exposure to high stress and frequent work interruptions.
2. Exposure to cleaning agents and disinfectants.
3. Exposure to toxic gas, fumes, and odors.
4. Exposure to electrical current.
5. Exposure to radiation from radiology equipment.

JOB DUTIES

ELECTONIC HEALTH RECORDS (EMR)

• Demonstrates capabilities of use of computers and EMR for documenting required data.
• Documents assessment, plan, interactions, and interventions according to departmental guidelines and standards.
• Prepares and/or assist in the preparation of discharge letters.
• Collects data of behavioral health services provided and referred out.

MEDICATION ASSISTANCE PROGRAM

• Assists patients with applying for program by accepting referrals, setting appointments for eligibility review and completing application process.
• Serves as advocate for patients with providers and pharmaceutical companies.
• Keeps accurate records of medications ordered and received.
• Manages mediation diversion program
• Documents order status in patient medical record.
• Assists with refill requests.

FINANCIAL ASSISTANCE

• Assists with sliding fee applications.
• Assist in obtaining prior authorizations from third party carriers.
• Assists with public health insurance applications such as WVCHIP and Medicaid.

REFERRALS

• Coordinates patient needs with local agencies to provide for care needs: WVDHHR, home health, hospice, mental health, personal care, medical supplies, transportation, etc.
• Develops and implements efficient referral process and documents.
• Works with inpatient units to secure beds for admission when needed.

ASSESSMENT/SUPPORT

• Provides screening and/or assessment of cognitive and psychological functioning.
• Provides supportive counseling to enable coping skills with illness, grief and/or trauma.
• Makes proactive contact to improve patient outcomes, increase patient compliance, and improve patient recall and retention.
• Provides crisis response.
• Utilizes motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Assists in the coordination and development of realistic and appropriate time limited case-plans, goals, objectives and measurable outcomes.

SCHOOL COLLABORATION

• Collaborates with referring party.
• Researches, develops, and implements services at tier 1 and tier 2 levels.
• Provides psychoeducation to administration, teachers, parents, and students
• Documents all interactions with students, school staff, and parents.

QUALITY IMPROVEMENT

• Assists in planning, implementing and evaluating QI strategies.
• Provides monthly QI reports to supervisor.

COMMUNICATION

• Demonstrates knowledge of and adherence to patient rights and confidentiality according to policy.
• Serves as a patient advocate, acting as a liaison between patient, family and physician.
• Communicates with tact and diplomacy.
• Communicates clients progress by participating in multi-disciplinary health care team meetings and evaluations.

SAFETY

• Demonstrates knowledge of and compliance with safety policies and procedures.
• Maintain a working knowledge of relevant medical/legal issues that impact on patient care, e.g., advance directives, child and elder abuse.

OUTREACH ACTIVITIES

• Researches, prepares, and implements grant opportunities.
• Prepares reports required for specific grants.
• Coordinates and provide educational opportunities related to adaptation to the patients diagnosis, illness, treatment and/or life situation.
• Maintain working knowledge of and liaison with community agencies and resources.
• Implements marketing strategies as approved by administration.
• Serves on the marketing committee and assists with ongoing strategies and developing annual marketing plans, such as newspaper articles and brochures.
• Works in collaboration with the Community Outreach and Business Development Worker.

OTHER

Performs other duties as assigned by the supervisor.

Qualifications

QUALIFICATIONS:

1. Bachelors Degree in Social Work or other related field.
2. One year experience in behavioral health field preferred.
3. Current WV Social Work licensure preferred.
4. Ability to communicate effectively, both verbal and written.
5. Must demonstrate ability to communicate and to use tact and diplomacy in dealing with physicians, patients, families, the school system and other health care professionals.
6. Ability to work independently while being able to communicate with other employees.
7. Ability to assess complex situations and develop a realistic, appropriate and safe plan.
8. Must demonstrate characteristics of dependability and punctuality.

Salary : $32,100 - $40,700