Behavioral Health Case Manager, Behavioral Health Patient Access

Heywood Hospital; Gardner (MA); On-site; USD 34,000 - 45,000; Full time

Job summary

Heywood Hospital is seeking a Behavioral Health Case Manager to coordinate care for patients evaluated in the Emergency Department. This role includes referring patients to psychiatric inpatient placements or community services and providing brief mental health support during discharge follow-up calls.

The position requires verifying insurance and obtaining prior authorizations when needed, with a foundational understanding of the mental health and social services systems.

Qualifications

• Bachelor’s degree in a human services field preferred or equivalent lived experience navigating the behavioral health system for a loved one or themselves.
• At least 2 years of case management experience preferred.
• Familiarity with navigating EMR systems and PointClick Care platform preferred.

Responsibilities

• Assists with providing mental health support during crisis evaluation and discharge follow up.
• Coordinates care by linking patients to local behavioral health resources and referring to appropriate services.
• Coordinates bed searches for psychiatric inpatient units or step-down placements for patients in ED or med-surg units.
• Completes insurance verifications and obtains prior authorizations when required.
• Supports clinicians by facilitating collateral contact with families, providers, and community partners.
• Collaborates with ED, inpatient staff and community partners to ensure continuity of care.
• Maintains timely EMR documentation and adheres to privacy requirements.
• Promotes teamwork, accountability, and patient-centered care.
• Other duties as assigned.

Skills

Behavioral health knowledge

Phone-based support

Care coordination

Insurance verification

Prior authorizations

Communication skills

Organization

Problem solving

Education

Bachelor’s degree in human services

Tools

EMR (PointClickCare)

Job description

Overview

You Matter Here!

Heywood Healthcare values our employees! We offer competitive wages, great benefits and generous earned time off. Come work where you will matter!

Hours: 40-Hours, Days

$25.05 - $33.05

We are committed to equitable and transparent compensation practices. The salary range for this position reflects our good-faithestimate of base pay at the time of posting. Final compensation will be determined based on a variety of factors, including relevant experience, skills, qualifications, and internal equity. We regularly review our compensation structures to ensure fairness and consistency across our organization.

Job Summary:

The Behavioral Health Case Manager is responsible for coordinating care for patients who are evaluated in the Emergency Department. This includes referring the patient to psychiatric inpatient placements and/or community based services. The Behavioral Health Case Manager will also provide brief mental health support during discharge follow up calls. They will verify patients’ insurance & obtain prior authorizations for placements when necessary. The Behavioral Health Case Manager should have at least a basic understanding of the mental health & social services systems.

Responsibilities

Essential Functions

• Assists with providing mental health support during crisis evaluation (when needed) & during discharge follow up calls.
• Coordinates care for patients by getting them connected to local behavioral health resources and referring patients to the appropriate services.
• Coordinates bed searches for patients requiring admission to a psychiatric inpatient unit or a step-down placement (ie. CBAT/YCCS, CCS), for patients boarding in the Emergency Department or med-surg units.
• Completes insurance verifications for all patients and obtains prior authorizations when required.
• Assists clinicians with facilitating collateral contact with families, providers, and community support.
• Collaborates with the Emergency Department, inpatient staff and community partners to ensure continuity of care.
• Maintain timely and accurate EMR documentation throughout the referral and admission process while adhering to all patient privacy and confidentiality requirements.
• Promote a culture of teamwork, accountability, and patient-centered care.
• Other duties as assigned.

Statement of Other Duties

This document describes the major duties and responsibilities for this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described.

Functional Demands

Exerts up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Frequently reaches (extending hands and arms in any direction), and handles (seizing, holding, grasping, turning, or working with hands).

Qualifications

Job Requirements

Minimum Education

• Bachelor’s degree in a human services field preferred or equivalent lived experience navigating the behavioral health system for a loved one or themselves and who could serve as a Peer Support for patients when appropriate.

Minimum Work Experience

• At least 2 years of case management experience preferred.
• At least 2 years working in a behavioral health setting preferred.
• Familiarity with navigating Electronic Medical Records (EMR) system & Point Click Care platform preferred.

Required Skills

• Knowledgeable about the behavioral health system & local community resources.
• Comfortable with providing brief mental health support to patients over the phone.
• Ability to coordinate care for patients with behavioral health challenges.
• Knowledge of insurance verification processes & obtaining prior authorizations.
• Effective communication and interpersonal skills.
• Excellent organizational and problem-solving abilities.