Behavioral Health Case Manager

ECU Health; Greenville (NC); On-site; USD 69,000 - 100,000; Full time

Job summary

ECU Health Medical Center in North Carolina is seeking an experienced case management professional to coordinate discharge planning and care transitions across the continuum of care. You will oversee a designated caseload, ensuring timely assessments, planning, implementation and evaluation within CMS guidelines.

This role requires an advanced degree and North Carolina licensure, strong collaboration with health care teams, and meticulous documentation.

Qualifications

• Master's degree in Social Work, Counseling (Clinical), or Marriage & Family Therapy.
• North Carolina full licensure as Social Worker (LCSW), Counselor (LCMHC) or LMFT.
• Non-Violent Crises Intervention certification within 60 days of hire for inpatient roles.

Responsibilities

• Coordinate discharge planning and care transitions across the continuum of care.
• Monitor census, assign assessments for case management needs and care coordination.
• Communicate findings to care teams and arrange Homecare, DME, Transportation, and SNF/Acute Rehab as needed.
• Maintain documentation per guidelines; prepare reports and maintain records.
• Collaborate with Utilization Management to support payer negotiations and denial prevention.

Skills

Case management

Care coordination

Interdisciplinary teamwork

Education

Master's degree in Social Work, Counseling (Clinical), or Marriage & Family Therapy

Job description

Position Summary

Manage a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System's resources and perform these duties within the requirements of CMS and other external review agencies.

Responsibilities

Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.

Maintain effective communication with health care team members related to assessment findings, discharge planning needs and provider orders needed to arrange Homecare, Durable Medical Equipment, Transportation, Skilled Nursing or Acute Rehab Facility placement, Substance Abuse Treatment and outpatient follow-up.

Maintain working knowledge of specific benefits and reimbursement guidelines, the discharge planning process and applicable federal, state and local regulations. Provide education and guidance on these topics to providers, patients and families as needed.

Work with Utilization Management partners to provide information and feedback that will enhance negotiations and denial prevention with payers.

Maintain timely documentation of assessment findings, discharge arrangements and actions taken according to departmental guidelines; prepare reports and maintain records as requested and/or required.

Monitor daily census and assignment to assure all patients are assessed for case management needs including care coordination/transition and discharge planning, consultations, advocacy, education.

Seeks direction when indicated for unusual or non-routine duties; advise appropriate personnel (i.e., Supervisor) of situations requiring nursing, administrative or technical expertise and follow-up; establishes and maintains positive, productive working relationships within the department/service line team as well as with other ECU Health departments; and, recognizes which decisions may be made independently and which require team and/or supervisory input and when this recognition is made, pursues the course of action in an efficient manner.

Orients new team members to the role when assigned.

Minimum Requirements

Master's degree in Social Work , Counseling (Clinical), and/or Marriage & Family Therapy, (may consider Master's in Psychology if full licensure as any of the above disciplines has been obtained).

North Carolina full licensure to practice as professional Social Worker (LCSW), Counselor (LCMHC), or Marriage& Family Therapist (LMFT).

Non-Violent Crises Intervention certification within 60 days of hire for all inpatient roles required.

3 years of relevant clinical case management experience required.

Pay Range

$68,806 - $100,294

ECU Health

About ECU Health Medical Center

ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary teaching hospital for The Brody School of Medicine at East Carolina University. ECU Health Medical Center has achieved Magnet® designation twice and provides acute and intermediate care, rehabilitation and outpatient health services to a 29-county region that is home to more than 1.4 million people.