BH Case Manager: Weekend Program

American Addiction Centers; Milwaukee (WI); On-site; USD 45,000 - 69,000; Part time

Benefits offered by this job

Paid Time Off

Health and welfare benefits

Flexible Spending Accounts

Family benefits

Retirement plans with employer match

Educational Assistance Program

Job summary

Advocate Health is seeking a part-time case management professional to coordinate discharge plans at Aurora Behavioral Health Services in Milwaukee. The role involves collaboration with physicians, families, and payors, with flexibility on start times and a Friday–Sunday shift from 7:30 AM to 4:00 PM.

Must hold relevant Wisconsin licenses and a strong background in behavioral health. Responsibilities include reviewing clinical data, obtaining authorizations, and guiding patients through

Qualifications

• RN licensure in Wisconsin or applicable state.
• Wisconsin Social Worker license, or equivalent.
• Wisconsin Professional Counselor license, or equivalent.
• AHA Basic Life Support certification.

Responsibilities

• Coordinates discharge planning with specialty services and families.
• Explains estimated benefits and assists with financial options.
• Obtains pre-authorization and conducts ongoing payor reviews.
• Initiates denial/appeal processes for non-certified care.
• Leads and participates in treatment team meetings and ensures policy adherence.

Skills

Leadership

Communication

Reimbursement knowledge

Discharge planning

Multidisciplinary collaboration

Education

Bachelor’s Degree in Nursing

Master’s Degree in Social Work

Master’s Degree in Psychology/Counseling

Job description

Department:

11200 Aurora Psychiatric Hospital - Case Management

Status:

Part time

Benefits Eligible:

No

Hou** rs Per Week:

Schedule Details/Additional Information:

Position is every Friday, Saturday and Sunday from 0730 to 1600. Start time is flexible. Must be available to 1700 via Pager, if needed. Per weekend program policy one weekend off per quarter.

Pay Range

$33.05 - $49.60

Major Responsibilities:

• Coordinates discharge planning, utilizing specialty services as needed. Monitors and ensures the discharge plans are completed in a timely manner. Facilitates calls to specialists as ordered (i.e. primary care physician, therapists). Works with families providing information and education services as needed.
• Reviews clinical/insurance information and completes data gathering if necessary. Explains estimated benefit information to patient and assist the patient in exploring financial options as needed.
• Obtains pre-authorization from managed care company. Performs ongoing concurrent reviews with payor source, maintaining written records of contacts. Investigates and negotiates different care options with the payor source/insurance company. Keeps the physician, treatment team, patient, family and financial counselor aware of review status.
• Initiates the denial/appeal process for non-certified care, following through with all required paperwork and communications.
• Assists with the development and maintenance of standards for case management across the Aurora Behavioral Health Services system.
• Facilitates communications between and negotiates with the patient/family, physicians, nurses, dietary, rehab, homecare, social services, and other disciplines that need to collaborate to provide care for the patient.
• Collaborates and coordinates efforts with treatment team members to complete the discharge plan in a timely manner. Attends and participates in treatment teams and unit meetings and may be assigned to lead and coordinate meetings as needed.
• Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirements relative to his/her age-specific needs, and to provide the care needed as described in the department’s policies and procedures. Age-specific information is developed further in the departmental job standards.

Licensure, Registration, and/or Certification Required:

• Registered Nurse license issued by the state in which the team member practices, or
• Social Worker license issued by the state of Wisconsin, or
• Professional Counselor license issued by the state of Wisconsin, and
• Basic Life Support (BLS) for Healthcare Providerscertification issued by the American Heart Association (AHA).

Education Required:

• Bachelor’s Degree in Nursing, or
• Master’s Degree in Social Work, or
• Master’s Degree in Psychology, Counseling.

Experience Required:

• Typically requires 3 years of experience in behavioral health services that includes experiences in assessments, discharge planning and utilization review in a managed care environment.

Knowledge, Skills & Abilities Required:

• Demonstrated leadership skills and ability to work independently.
• Must have excellent oral, written communication and problem solving skills.
• Demonstrated working knowledge of reimbursement methods and referral sources.
• Demonstrated working knowledge of the State of Wisconsin Mental Health and Developmental Disabilities Code.
• Knowledge of state and federal mental health and chemical dependency regulations.

Physical Requirements and Working Conditions:

• Will frequently be required to lift 25 lbs. without assistance.
• Will occasionally be required to lift over 25 lbs. with assistance.
• May be exposed to the following hazards: mechanical, chemical, blood and body fluids.
• Must be able to sit, stand, walk, squat, bend, and reach above shoulders and twist.
• Ability to utilize proper de-escalation techniques when working with agitated patients.
• Demonstrates flexibility in an environment that requires the ability to multitask.
• Operates all equipment necessary to perform the job.
• Any exception to the above requirements must be demonstrated through Employee Health.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate’s job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full‑time, part‑time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third‑largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience, and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.