Psychiatric Case Manager

Lake Charles Memorial Health System; Lake Charles (LA); On-site; USD 60,000 - 80,000; Full time

Job summary

Lake Charles Memorial Health System is seeking a Psychiatric Case Manager to supervise day-to-day functions and improve department efficiency. The ideal candidate will possess a BA or Nursing Certification and have 3-5 years of experience in mental health or addiction.

This role includes conducting utilization reviews, maintaining regulatory compliance, and evaluating patient progress. The work environment requires adaptability and strong communication skills.

Qualifications

• BA required, Social Work preferred OR Nursing Certification with RN preferred.
• Minimal 3-5 years experience working with mentally ill and/or addictions required.
• Ability to communicate with patient, family, peers, and medical personnel.

Responsibilities

• Supervises day-to-day functions of the department and staff.
• Performs utilization review in accordance with all state mandated regulations.
• Obtains and reviews necessary medical reports and treatment plans.

Skills

Utilization review

Communication

Emotional stability

Organizational leadership

Education

BA in Social Work or Nursing Certification (RN)

Louisiana Nursing License or multi-state compact nursing license

Job description

Overview

The Psychiatric Case Manager supervises day-to-day functions of the department and staff. The manager actively seeks areas for the department to improve (e.g., reduction in denials) and/or to be more efficient.

Supervision

Reports directly to Director of Psychiatric Services

Responsibilities And Duties

• 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 and processes requests for appeal of denials.
• Attends required meetings regarding approvals, denials, pre-certs, authorizations and retro reviews.

Education And Work Experience

• BA required, Social Work preferred OR Nursing Certification with RN preferred
• Minimal 3-5 years experience working with mentally ill and/or addictions required
• Louisiana Nursing License or multi-state compact nursing license preferred, 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.

Physical Demands / Work Environment

• Work requires a variety of physical activities including sitting, standing and walking.
• Bending, stooping, and lifting are minimal.
• The work environment may be physically confining.
• Visual acuity required for a variety of activities.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.