The Case Management/Utilization Review Manager in conjunction with the Program Director coordinates all aspects of Case Management, Program and UR functions in the Department. DUTIES INCLUDE BUT ARE NOT LIMITED TO
• Manages all aspects of Case Management, Clinical Programs, Clinical Treatment and UR including, but not limited to, best practice initiatives; treatment planning; compliance with all regulations; FTE management; and referrals to the continuum.
• Proactively manages outcome measures, patient satisfaction, HBIPS and other important monthly processes.
• Actively assesse and reassesses departmental needs and provides strategies for change.
• Integral part of the management team working closely with other manager especially with referral development in the continuum.
• Provides monthly reports as determined, including UR and Case Management data.
• Demonstrates good judgment in handling situations not covered by verbal or written instructions.
• Follows established policy and procedures in performing job functions.
• Interacts and communicates with others in a way that promotes a positive and cooperative work environment.
• Demonstrate effective problem solving skills, channels concerns appropriately and demonstrate the ability to provide input, suggestions and support
• Demonstrates ability to set priorities and demonstrates a thorough knowledge of work practices.
• Ensures patient rights and confidentiality.
• Able to assess and reassess needs of patients.
• Works collaboratively with hospital departments to assist managing behavioral health assessment needs.
• Participates as an active member of the multidisciplinary team.
• Coordinates and participates with appropriate interested parties and physicians through the patient referral inquiry, admission, treatment and discharge process.
• Performs other duties as assigned by Program Director.
• Other duties as assigned.Qualifications: KNOWLEDGE, SKILLS AND ABILITIES
- Posses a thorough knowledge of current behavioral health concepts, principles and methods of treatment.
• Possess good communication skills verbal and written.
• Possess good organization skills and be able to act on multiple tasks.
• Understand and be able to train on all the state and federal standards regarding behavioral health assessment, petition, medical screening and patient rights. EDUCATION
Graduation from an accredited College or University. EXPERIENCE
- Prefer 1-3 years experience in a behavioral healthcare setting performing clinical assessments or in a clinical treatment setting. Prefer 1-3 years experience with Utilization Review.
- Required: Licensed in the State of Virginia as an LCSW or LPC
• Preferred: Licensed in the State of Virginia as an LCSW PHYSICAL DEMANDS/WORKING CONDITIONS
- Position requires ability to lift up to 25lbs and travel multiple hours per week in the offsite clinical assessments of patients. Work is indoors and outdoors.
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom