Patient Care Manager Behavioral Health
4 weeks ago
Description
Patient Care Manager IP BH Job Code: 1047 Job Summary Provides direct clinical services to patients within Munson Medical Center Inpatient Behavioral Health services. Clinical services include assessment, diagnosis, person-centered treatment planning, therapy, counseling, education, coordination of community resources and the documentation, knowledge of insurance benefits and authorization/utilization management activities required from each insurance company. Education and Experience EDUCATION/EXPERIENCE Min/Preferred Education Level and/or Years of Experience Comments Required Graduate Degree Master's degree from a social work, psychology, and/or counseling accredited program. Preferred 3 Or 6000 hours of counseling and/or related experience CERTIFICATION, LICENSURE, REGISTRATION Min/Preferred Certification, Licensure, Registration Comments Minimum Michigan License to provide behavioral health counseling May be a LMSW, LPC, or LLP. With manager approval, Limited Licensed individuals may be considered. Key Competencies and Skills- li",201340122,"2",134233614,"true",469778129,"ulli",335572020,"1",469778324,"Normal"]}" >Demonstrated knowledge and proficiency in behavioral health assessment and treatment of substance use disorder, mental health, and co-occurring disorder interventions and applications with a focus on evidence-based practices.
- Must be flexible, self-motivated, non-judgmental – meeting people where they are in their recovery.
- Must have ability to create a solid person-centered treatment plan with the knowledge and application of insurance benefits, authorizations, utilization management and coordination of other community resources to best meet the needs/choices of the person served.
- Provides individualized treatment services that are evidence-based to improve health, wellness, and quality of life for patients.
- Provides clinical coverage for treatment groups/psycho-educational sessions as needed to support the clinic needs.
- Demonstrates competency through the annual discussion process, patient feedback, clinical staff dialogue, performance appraisals and staff education.
- Completes all documentation within the timelines required of the treatment process in accordance with hospital, departmental, and regulatory agency requirements. This documentation includes all treatment authorizations as needed to receive approval for services.
- Demonstrates knowledge, skills, and ability to effectively respond to behavioral health crises and make appropriate recommendations.
- Co-creates individualized treatment plans with patients with measurable outcomes.
- Provides care coordination and advocacy to enhance access to community resources. Provides care coordination with other providers to enhance communication, efficiency, and effectiveness of care.
- Communicates with other members of the health care team through case reviews to ensure a safe continuum of care.
- Understands the specific behavioral health benefits of the person-served and provides required requests for authorizations for services to help ensure payment for services rendered.
- Monitors authorizations and provides utilization management activities required of the payer for the behavioral health services that are rendered.
- Identifies quality improvement needs and participates in implementing improvements.
- Maintains effective communications with patients, families, team members and managers as evidenced by mutual support, open communication, trust, and support.
- Promotes good public relations with department personnel, physicians, other referral sources, patients, families, and the community.
- Assumes responsibility for continuing education and professional development by attending required in-services and other means of continuing professional education (e.g., readings, classes, workshops).
- Adheres to all hospital and department policies.
- Keeps manager and physician informed of activities, decisions, and changes in patients' treatment and/or progress.
- Provides the Manager with input regarding competencies and annual discussions and assists with implementation of hospital and departmental policies and procedures.
- Keeps manager and physician informed of activities, decisions, and changes in patients' treatment and/or progress.
- Adheres to all hospital and department policies.
- Assumes responsibility for continuing education and professional development by attending required in-services and other means of continuing professional education (e.g., readings, classes, workshops).
- Promotes good public relations with department personnel, physicians, other referral sources, patients, families, and the community.
- Maintains effective communications with patients, families, team members and managers as evidenced by mutual support, open communication, trust, and support.
- Identifies quality improvement needs and participates in implementing improvements.
- Monitors authorizations and provides utilization management activities required of the payer for the behavioral health services that are rendered.
- Understands the specific behavioral health benefits of the person-served and provides required requests for authorizations for services to help ensure payment for services rendered.
- Communicates with other members of the health care team through case reviews to ensure a safe continuum of care.
- Provides care coordination and advocacy to enhance access to community resources. Provides care coordination with other providers to enhance communication, efficiency, and effectiveness of care.
- Co-creates individualized treatment plans with patients with measurable outcomes.
- Demonstrates knowledge, skills, and ability to effectively respond to behavioral health crises and make appropriate recommendations.
- Completes all documentation within the timelines required of the treatment process in accordance with hospital, departmental, and regulatory agency requirements. This documentation includes all treatment authorizations as needed to receive approval for services.
- Demonstrates competency through the annual discussion process, patient feedback, clinical staff dialogue, performance appraisals and staff education.
- Provides clinical coverage for treatment groups/psycho-educational sessions as needed to support the clinic needs.
- Must be flexible, self-motivated, non-judgmental – meeting people where they are in their recovery.
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