Job Summary:

The BHC Case Manager, Licensed should have advance knowledge and understanding of mental health and substance abuse diagnoses; acute inpatient symptoms and interventions; the psychosocial impact of behavioral health on patients and families. The candidate will have the capacity to conduct case certifications and reviews to present rationale for level of care, LOS, interventions and discharge plans. They must have the ability to deliver these functions for all payer sources.

Responsibilities:

• Reviews patient charts to ensure that Westchester Medical Center is in compliance with required standards.
• Screens patients' charts concurrently and/or retrospectively, using approved screening criteria for Quality Management and Utilization Management issues.
• Participates in patient care monitoring.
• Evaluates clinical management and/or outcome of treatment.
• Assesses and responds to patient/family needs by coordinating efforts of the team members.
• Reviews daily census and forwards abstracts to appropriate coordinator to ensure ongoing review of patient care.
• Identifies quality care issues which have the potential for impact on the process and outcome of the treatment of patients.
• Confers with the treatment team members, if indicated, when occurrences are identified, and assists in the development of corrective action.
• Conducts discharge planning services for patients.
• Participates in weekly multi-disciplinary team discharge planning meetings.
• Completes PRI or DMS-1 forms for patients being discharged to nursing homes, adult homes, rehabilitation facilities.
• Initiates discharge process for completing PRI form and contacting Nursing Supervisor for transfers back to Skilled Nursing Facilities.
• Identifies potential discharge problems and bringing them to the attention of the social work staff via Discharge Planning Referral platforms.
• Screen patient's chart on admission, concurrently and/or retrospectively, using approved clinical guidelines in Utilization Management.
• Collaborates with the team members to ensure safe and timely care against clinical guidelines and best practices and ensures a safe and timely discharge.
• Represents the hospital on community committees; act as liaison and coordinator between hospital and community.
• Participates and contributes in multi-disciplinary treatment team rounds in continually monitoring patient care assessments to ensure patient is moving towards desired outcomes.
• Participates in continuing education.
• Assumes a pivotal role in the discharge planning process for all patients.
• Identifies potential discharge problems and brings them to the attention of the treatment team.
• Works with patients legal guardians/caregivers/collateral contacts in creating a personalized treatment plan.
• Confers with the treatment team members, if indicated to ensure the safe and timely care against clinical guidelines and best practices and ensures a safe and timely discharge.
• Completes PRI screens as indicated.
• Monitor the length of stay and resource consumption of patients.
• Access protected health information (PHI) in accordance with departmental assignments and guidelines defining levels of access.
• Supervision may be exercised over a small number of support staff.
• Knowledge of regulatory agency standards Centers for Medicare & Medicaid Services, Office of Mental Health and Det Norske Veritas (DNV) standards.

Experience:

Minimum of 2 years post graduate experience in medical, mental health or human services setting as a member of a multi-disciplinary team, required.

Education:

Master's degree from an accredited graduate school, required.

Licenses / Certifications:

Possession of a valid license and current registration as an LCSW/LMSW/LMHC , issued by the New York State Education Department.

Other:

The candidate must possess excellent oral and written skills, and computer skills. They need to have shown an ability to function independently and possess demonstrated experience in conducting interviews and interventions with complex and problematic clients to obtain social and medical information necessary to determine appropriate discharge plan.

About Us:

WMC Advanced Physician Services PC