Case Management Coordinator

East Tennessee Behavioral Health; Knoxville (TN); On-site; USD 42,000 - 65,000; Full time

Job summary

East Tennessee Behavioral Health is seeking a case management professional to assess, plan, implement, and coordinate care for residents during treatment. You will monitor and evaluate services and collaborate with the treatment team and community agencies to ensure continuity of care.

Responsibilities include admission review, care plan development, precertification with payers, discharge planning, and effective communication with insurers and business office as needed.

Qualifications

• Bachelor's degree required or relevant experience.
• Ability to liaise with community agencies to ensure continuity of care.
• Knowledge of mental health and substance use fields preferred.

Responsibilities

• Assess admission criteria and review initial clinical information.
• Develop and monitor individual care plans with ongoing documentation review.
• Coordinate inpatient or outpatient care and report on progress.
• Communicate with insurers and treatment team regarding medical criteria.
• Handle precertification with third party payers and negotiate admission days.
• Support discharge planning and admission review tasks.

Skills

Interagency liaison

Communication skills

Clinical data management

Education

Bachelor's degree in Health Administration, Social Science or related field

Job description

Purpose Statement

Assess, plan, implement, coordinate, monitor and evaluate services to meet an individual’s needs during treatment.

Purpose Statement

Assess, plan, implement, coordinate, monitor and evaluate services to meet an individual’s needs during treatment.

Essential Functions

• Assure residents meet criteria for admission, and review initial clinical information through discharge.


• Monitor and manage client/patient/resident’s cases through development and implementation of individual care plans, collecting clinical data and remain informed by continuous review of documentation.


• Coordinate care by tracking, monitoring, and reporting on inpatient or outpatient care.


• Manage client/patient/resident’s cases with knowledge and expertise with the patient population of the facility.


• Convey medical criteria and clinical information between the client/patient/residents’ insurance provider and treatment team as warranted and may also provide this information to the business office, as needed.


• Conduct precertification with third party payers and negotiate approved days with the provider for the patient/resident admission.


• Assigned tasks for admission review, concurrent review and participate in discharge planning.

Other Functions

• Perform other functions and tasks as assigned.

Education/Experience/Skill Requirements

• Bachelor’s degree in Health Administration, Social Science or a related field or relevant previous job experience required.


• Ability to create and maintain professional liaison with community agencies and organizations to ensure continuity of care.


• Knowledge of mental health and substance use fields is preferred.

Licenses/Designations/Certifications

CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).

• First aid may be required based on state or facility.

EASTN

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.