- 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.
- 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.
- 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.
- 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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Psychiatric Case Manager - Lake Charles, United States - Lake Charles Memorial Hospital
Description
Archer Administration Psychiatric Case Manager (Utilization Review)DESCRIPTION OF POSITION:
RESPONSIBILITIES AND DUTIES:
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job.
EDUCATION AND WORK EXPERIENCE
