Mental Health Case Manager

1 week ago

Pocono Lake, United States PCS Mental Health Full time
Job Overview

Our Purpose:

Empower individuals facing significant mental health challenges, including co-occurring substance use disorders and dual diagnoses, to lead fulfilling lives within their communities, defined by their own terms.

Position: Social Worker (SW)

Reports To: Program Director

Role Summary:

Deliver social work and case management services to Members, collaborating with families and various stakeholders to ensure seamless care coordination.

Key Responsibilities:

  • Work with admissions to assist in the onboarding and integration of new Members into the program.
  • Prepare Incident Reports following the guidelines set by the Managed Care Organization (MCO), State regulations, and Project Transition policies.
  • Collaborate with the multidisciplinary team to formulate treatment plans for identified Members.
  • Conduct monthly individual sessions with Members and document findings in DAP format within 24 hours.
  • Provide comprehensive case management services to Members, including but not limited to:
  1. Facilitating financial eligibility and benefits coordination
  2. Coordinating family engagement and support
  3. Conducting utilization and member care assessments with MCOs and other insurers.
  4. Monitoring member authorizations and timely input into the Electronic Health Record (EHR).
  5. Generating authorization reports and other necessary reports in the EHR as assigned.
  6. Managing Level of Care adjustments and aftercare planning documentation with Members.
  7. Resolving billing discrepancies promptly.
  8. Communicating with referral sources and external supports (hospitals, rehabilitation centers, etc.) to ensure successful transitions for Members back to the program.
  9. Assist Members with ongoing transition planning through the APPLE Plan.
  10. Conduct discharge follow-ups for all Members in accordance with PT/PCS procedures.
Facilitate or co-facilitate assigned group sessions and complete documentation within 24 hours.Assist with Member transportation as directed by the Program Director.Observe Member alcohol and drug screenings and document findings within 24 hours (if applicable).Supervise Member self-administration of medication as assigned.Engage in phone coaching/crisis management, which includes:
  1. Orienting Members and families to the phone coaching process.
  2. Being available for coaching calls on assigned days, including responding to emergencies during low staff coverage.
  3. Providing coverage for staff absences.
  4. Following incident reporting and documentation protocols for all on-call emergencies.
Offer backup support to the Program Director as needed.Complete continuing education requirements in line with regulatory standards.Attend individual supervision sessions and program meetings as scheduled by the direct supervisor.Perform other duties as assigned by the Program Director.

Performance Expectations:

  • Participate in multidisciplinary treatment teams, supporting and implementing interventions as directed.
  • Exhibit compassion and concern while assisting Members, aligning with Project Transition and PCS Mental Health's Mission and Core Values.
  • Engage with Members from a non-judgmental perspective, recognizing that behavior may stem from past experiences, including trauma.
  • Communicate with Members respectfully and kindly, even during challenging emotional situations, ensuring dignity and respect for their values and lifestyles.
  • Seek guidance from Clinicians or Psychiatrists, in conjunction with the Program Director, when uncertain about how to effectively support a Member.
  • Report observations of Member behavior to the Treatment Team, particularly if additional interventions or support may be necessary.
  • Interact with all external parties with professionalism and a positive customer service approach, representing the organization appropriately.

Qualifications:

  • Bachelor's degree in social work or a related field with at least 1 year of experience in Mental Health, Behavioral Health, or Substance Use fields, or another bachelor's degree with 2 years of relevant experience.
  • Minimum of two years' experience in case management, family support, and care collaboration.
  • Strong skills in assessment and documentation.
  • Excellent communication, interpersonal, organizational, and time management abilities.
  • Proven ability to work effectively within a multidisciplinary team.
  • High-energy individual with a strong work ethic and the capacity to manage multiple tasks.
  • Ability to work independently and maintain confidentiality.

Benefits for Full-Time Employees:

  • Paid Time Off
  • Health Insurance available within 60 days of hire
  • Company Paid Life Insurance
  • Short-Term and Long-Term Disability Insurance
  • Dental Insurance
  • Vision Insurance
  • Health Spending Accounts
  • Eligibility to participate in company 401K after 6 months of employment
  • Company 401K match up to 3%

Access to Employee Assistance Program for all Employees

We are an equal opportunity employer. All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

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