BH Case Manager: Weekend Program

199 Aurora Psychiatric Hospital, Inc.; New York (NY); On-site; USD 42,617,000 - 63,988,000; Part time

Benefits offered by this job

Total rewards program

Paid time off

Health and welfare benefits

Flexible Spending Accounts

Adoption assistance

Employer retirement match

Education assistance

Job summary

Advocate Health's Aurora Psychiatric Hospital is seeking a part-time Case Management professional to coordinate discharge planning and support families and care teams. The role requires nursing or social work licensure in Wisconsin, and experience in behavioral health and utilization review.

Expect collaboration with physicians, therapists and payors, with a focus on timely, patient-centered outcomes. The role supports weekend shifts (Friday–Sunday) and includes cross-functional communication,

Qualifications

• Requires RN license or Social Worker license or Professional Counselor license (Wisconsin)
• Bachelor's in Nursing or Master's in Social Work/ Psychology required
• Experience in behavioral health and utilization review preferred
• Ability to lead and coordinate discharge planning
• Strong written and oral communication skills

Responsibilities

• Coordinate discharge planning and utilize specialty services as needed
• Monitor discharge plans and ensure timely completion
• Communicate with families, physicians, therapists and payors
• Explain estimated benefits and assist with financial options
• Initiate denial/appeal process when required
• Collaborate with treatment teams to complete discharge plans on time

Skills

Discharge planning

Communication skills

Collaboration with care team

Reimbursement knowledge

Education

Bachelor's in Nursing

Master's in Social Work

Master's in Psychology/Counseling

Job description

Job Overview

Department: 11200 Aurora Psychiatric Hospital - Case Management Status: Part time Benefits Eligible: No Hours Per Week: 18 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 Providers certification 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.

Our Commitment to You

• 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.
• 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.
• Paid Time Off programs.
• Health and welfare benefits such as medical, dental, vision, life, and Short- 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. This is Transformation One shared purpose brought us together. Now, as one of the 10 largest not‑for‑profit, integrated health systems in the United States, our combined strength and stability drives us forward. Starting with You Caring for nearly 3 million people has inspired a transformation. One in which the patient’s experience guides our vision and empowers us to offer new possibilities in our communities. Reshaping Access What is access? It’s offering more sites of care than any other health system in the Midwest. But there’s a new frontier. Access is exploring the latest technologies to deliver care to patients exactly where they are and exactly when they need it Inspiring Professionals With our dynamically inclusive workforce and strong connections to the places where we live and work, we’ll touch more lives and contribute to stronger and more vibrant communities. Transforming Care We’re redefining the standard for care with world‑class doctors and caregivers, innovative solutions, outstanding outcomes, and leading‑edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in: Cardiovascular Care Neurosciences Gynecology Oncology Pediatrics Primary Care Neurology Geriatrics Trauma Care