Psychiatric Case Manager

2 weeks ago


Lake Charles, United States Lake Charles Memorial Hospital Full time

Archer Administration Psychiatric Case Manager (Utilization Review)

DESCRIPTION OF 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.

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

* Degree in Social Services, Psychology or related filed; LPN/RN licensure preferred
* Minimal 5-7 Years Experience working with mentally ill &/or addictions
* Louisiana Nursing License or multi-state compact nursing license, Crisis Response Training, CPR
* Ability to communicate with patient, family, peers and medical personnel.
* Requires emotional stability and resilience.
* Must be adaptable to change, be decisive, and demonstrate foresight.
* Exhibits organizational and leadership ability.
* 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.


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