Job Details

DESCRIPTION OF POSITION:

* 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.

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, its the care we provide our patients and its 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.