Job Description:

DESCRIPTION SHIFT: No Weekends

SCHEDULE: Full-time

CASE MANAGER
MEDICAL CITY MCKINNEY
FULL TIME

Position Summary:
The Case Manager will coordinate the care and service delivery of Behavioral Health patients to promote effective utilization; monitor health care resources; and assume a leadership role with the interdisciplinary team to achieve optimal outcomes. Will insure that Behavioral Health patients are properly assessed and each patient is case managed in terms of proper and accurate payer identification, and complete and accurate data entry. Will work with the Admitting Department, PAS and the MCM Finance Departments to develop a timely and complete response to all payment denials and work daily to reduce outstanding patient debts. The coordinator will successfully interact with physicians, staff, patient/family and outside agencies. The ability to identify opportunities for on-going accuracy and improvement in the patient intake, assessment, clinical precertification and re-certification process is required. Assists in maintaining a safe and therapeutic milieu.

Job Duties:

* Communicates with patient, family, treatment team, physician and payers.

* Manages the utilization of services through initial reviews with payers and/or through internal reviews.

* Coordinates discharge planning activities.

* Helps to locate available resources and coordinates information to support patient disposition.

* Participates as a member of the multidisciplinary treatment team.

* Develops a treatment plan with specific goals delineating clinical intervention related to diagnosis for each patient.

* Facilitates psycho-educational groups for clients and family members of clients at Medical Center of McKinney.

* Facilitates family discharge meetings.

* Assures completion of discharge summaries/discharge instructions.

* Communicates and documents all relevant information to treatment team.

* Assists in the management of the utilization review functions.

* May collect insurance and referral information.

* May coordinate, implement and complete admission process.

* Demonstrates an understanding of and adherence to the Code of Conduct.

* Conducts that reflects the Company's values and a commitment to the Code of Conduct.

* Adheres to hospital policies and procedures.

* Assists in maintaining a safe and therapeutic milieu.

* Performs other duties as requested or required

QUALIFICATIONS Education/Experience Required:

* Master's level degree in Counseling or Social Work or RN with at least 2 years clinical experience in an acute care environment.

* Utilization review or case management background, and experience with the clinical precertification and recertification approval processes is strongly preferred.

* Knowledge of Medicare and Medicaid programs, psychiatric \\"carve-out\\" managed care and private payer requirements desirable as well as working knowledge of community and governmental resources.

License/Certification Required:

* Current license in the State of Texas.

We offer an excellent total compensation package, including competitive salary, comprehensive benefits and growth opportunities. Our benefits include 401k, PTO, medical, dental, flex spending, life, disability, employee discount program and employee stock purchase program. We would love to talk to you about this fantastic opportunity!

About Medical City McKinney:
Medical City McKinney is a growing 260-bed hospital with a 90-year history of serving the health care needs of McKinney and the surrounding communities. Over the past several years, we have strengthened our medical foundations by adding two new surgical robots, a newly remodeled labor and delivery suites, a Level III NICU and an advanced biplane Catheterization Lab to treat heart rhythm disorders.

Medical City McKinney is proud of our team for all the well-deserved recognitions and acknowledgements we've received to better serve you--Joint Commission accredited, Advanced (Level III) Trauma Center, Accredited Chest Pain Center, a Texas 10 Step Facility, CLIA certified laboratory; CAP accredited clinical and anatomical pathology services, \\"Top Performer on Key Quality Measures\\" for heart attack, heart failure, pneumonia and surgical care by Joint Commission and Intersocietal Commission of Vascular Labs in ultrasound for peripheral vascular ultrasound.

Our Talent Acquisition team is reviewing applications immediately. Highly qualified candidates will be contacted promptly for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

NOTICE

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