Psychiatric Case Manager - Full Time

Lake Charles Memorial Health; Lake Charles, Northern (LA, KY); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Lake Charles Memorial Health in Louisiana is seeking a Psychiatric Case Manager to supervise the day-to-day functions of the department and staff. The role focuses on identifying opportunities to reduce denials and improve efficiency while ensuring compliance with state regulations.

You will prepare notification letters, perform utilization review, review patient records, manage authorizations and denials, and participate in relevant meetings.

Qualifications

• Degree in Social Services, Psychology or related field is required.
• LPN/RN licensure preferred.
• Minimum 5–7 years' experience with mentally ill or addictions.
• Louisiana Nursing License or multi-state compact license, CPR.
• Strong communication with patients, families, peers and medical staff.
• Must be adaptable, decisive and show foresight; exhibit leadership.

Responsibilities

• Supervise day-to-day department functions and staff.
• Prepare information for notification letters for providers and employees.
• Perform utilization review according to state regulations.
• Maintain compliance with regulation changes affecting utilization management.
• Review medical records, patient progress, and treatment plans.
• Review and validate physician orders and reports.
• Process requests for appeal of denials and attend related meetings.

Skills

Communication

Emotional resilience

Leadership

Adaptability

Organizational skills

Education

Degree in Social Services or Psychology

LPN/RN licensure preferred

Job description

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

SUPERVISION:

Reports directly to the Practice Director

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 on-going 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.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• Degree in Social Services, Psychology or related filed; 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.

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.

“Experience Memorial” is more than a slogan, it’s the care we provide our patients and it’s the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.