Mental Health Case Manager & Utilization Lead

Lake Charles Memorial Hospital; Lake Charles, Northern (LA, KY); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Lake Charles Memorial Hospital is seeking a Psychiatric Case Manager to supervise daily department operations and lead staff toward improved efficiency, including reducing denials. The role reports directly to the Practice Director and centers on utilization review, documentation, and coordination of care for psychiatric patients.

The position requires a degree in Social Services or Psychology (LPN/RN preferred), 5–7 years working with mentally ill or addictions, and a Louisiana nursing license

Qualifications

• Degree in Social Services, Psychology or related field; LPN/RN licensure preferred.
• Minimal 5-7 Years Experience working with mentally ill &/or addictions.
• Louisiana Nursing License or multi-state compact nursing license, Crisis Response Training, CPR.
• Ability to communicate with patient, family, peers and medical personnel.
• Requires emotional stability and resilience.
• Must be adaptable to change, be decisive, and demonstrate foresight.
• Exhibits organizational and leadership ability.
• Shows ability to gain and maintain support and respect.

Responsibilities

• Prepares information for notification letters for providers and employees.
• Performs utilization review in accordance with all state mandated regulations.
• Maintains compliance with regulation changes affecting utilization management.
• Performs continuing review on medical records and identification and need of ongoing hospitalization.
• Reviews patients' records and evaluates patient progress.
• Obtains and reviews necessary medical reports and subsequent treatment plan requests to conduct review.
• Reviews and validates physician's orders, reports progress and unusual occurrences on patients.
• Receives & processes requests for appeal of denials.
• Attends required meetings regarding approvals, denials, pre-certs, authorizations and retro reviews.

Skills

Leadership

Communication

Education

Degree in Social Services/Psychology

LPN/RN licensure preferred

Louisiana Nursing License or multi-state license

Crisis Response Training

CPR

Job description

Lake Charles Memorial Hospital is seeking a Psychiatric Case Manager to supervise daily department operations and lead staff toward improved efficiency, including reducing denials. The role reports directly to the Practice Director and centers on utilization review, documentation, and coordination of care for psychiatric patients.

The position requires a degree in Social Services or Psychology (LPN/RN preferred), 5–7 years working with mentally ill or addictions, and a Louisiana nursing license