Case Manager - Behavioral Health
Core
Coordinates systems and services with a trans-disciplinary team approach to deliver quality, cost-efficient care to patients through the continuum of health care services.
Role type
Case Manager (Behavioral Health)
Builds
Patient care continuum and discharge planning
Domain
Healthcare / Behavioral Health
Required skills
Insurance verification, medical necessity assessment, benefits management, treatment team collaboration, discharge planning, data collection and record maintenance
Preferred skills
None stated
Technologies
None stated
Responsibilities
Assess data to determine medical necessity and appropriateness of level of care/admission based on approved criteria; Manage patient's benefits by checking insurance eligibility to optimize payment of services rendered; Attend weekly treatment team meetings with physicians, therapists, and nursing staff to discuss treatment options, benefits, insurance authorizations, and discharge planning; Collect, record, and maintain clinical information gathered from concurrent or retrospective review and assess for medical necessity criteria; Conduct appropriateness of admission and continued stay reviews concurrently or retrospectively; Work effectively with internal and external customers and proactively improve case management processes.
Seniority
Mid-level, hands-on IC