Inpatient Psychiatric Case Manager
1 day ago
As an Inpatient Psychiatric Case Manager at Kaiser, you will play a critical role in providing high-quality care to our members with acute and chronic psychiatric conditions. You will develop and implement treatment plans, coordinate services, and work closely with interdisciplinary teams to ensure optimal outcomes.
Key Responsibilities:- Case Management: Plan, develop, coordinate, assess, and evaluate services provided to members to promote quality and cost-effective outcomes.
- Policies and Procedures: Develop and maintain case management policies and procedures to ensure optimal and appropriate member utilization of services.
- Interdisciplinary Collaboration: Coordinate the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals for outside services.
- Care Path Development: Participate in the development of care paths to ensure effective and efficient care delivery.
- Crisis Management: Coordinate the care of a large caseload of high-risk patients and provide assessments and interventions in the community, including in-home visits.
- Communication and Collaboration: Consult with internal and external physicians, healthcare providers, discharge planning, and outside agencies regarding continued care/treatment or hospitalization.
- Follow-up and Referrals: Arrange and monitor follow-up appointments, make referrals to appropriate community services, and identify opportunities for cost savings and quality of care improvements.
- Data Collection and Analysis: Develop and collect reports and data, and trend utilization of healthcare resources.
- Training and Education: Develop and present in-service training and communication to both internal and external stakeholders.
- Regulatory Compliance: Interpret regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
- Communication and Coordination: Coordinate the transmission of clinical and benefit information and treatment to patients, families, and outside agencies, including issuing Non-Coverage and Denial of Benefits letters consistent with Health Plan Regulations.
- Liaison and Repatriation: Act as liaison to psychiatry clinics, outside agencies, non-plan facilities, and outside providers, and coordinate repatriation of patients and monitor their quality of care.
- Administrative Oversight: Provide administrative case management oversight to Inpatient Psychiatric Facilities, Crisis Residential Programs, and IMDs to ensure that services delivered to our members meet Kaiser's Quality and Utilization expectations and guidelines.
- On-Call and Documentation: Provide administrative on-call to the RSR/Sub regional Office and provide clinical and administrative documentation in accordance with Kaiser Regional Psychiatric Standards, including the Inpatient/Integrated Urgent Services Guidelines.
- Experience: Minimum two (2) years of experience in an inpatient psychiatric setting or psychiatric emergency service, and minimum two (2) years of experience in care management or clinical experience.
- Education: Masters degree (Social Work or Psychology), or PhD (Psychology) required.
- License, Certification, Registration: Psychologist License (California) OR Licensed Clinical Social Worker (California) OR Licensed Marriage and Family Therapist (California), and National Provider Identifier required at hire.
- Caseload Management: Responsibility for a large caseload for an extended period of time.
- Crisis Management Expertise: Demonstrated expertise in crisis management.
- Utilization Data Collection: Demonstrated experience in utilization data collection and cost benefit analysis.
- Regulatory Knowledge: Knowledge of TJC, and other local, state, and federal regulations.
- Collaboration: Must be able to work in a Labor Partnership Environment.
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