Case Specialist / Shore Behavioral Health (Dorchester) - Per Diem

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Job ID: 56162
Area of Interest: Professionals
Location: Cambridge, MD US
Hours of Work: Days/evening/weekends
Job Facility: UM Shore Regional Health
Employment Type: Supplemental/Per Diem
Shift: ROTATING
What You Will Do:

UM Shore Regional Medical Center is currently seeking a Case Specialist to join our Behavioral Health Department at Dorchester (Cambridge, MD).

This is a Per Diem/As Needed position - Day/Evening/Weekend coverage Needed - about 20 hours per month

Summary: Provides support to clinicians and direct services to clients and families. Assures continued stay approval by insurance and monitors accepted lengths of stay for optimal discharge planning.  Acts as a liaison to post-hospital care providers and community resources.  Supports System and Nursing Strategic Plans, Relationship-Based Care, and Shared Leadership.

  1. Assists Clinical Team in assessing appropriateness of medical necessity in accordance with Medicare, hospital and third party payer guidelines that govern admission, continued stay and discharges.
  2. Reviews admissions for discharge planning and identifies needs for referral to community agencies and aftercare providers.
  3. Secures placement or discharge services as needed, makes arrangements and prepares necessary forms to complete discharge process.
  4. Partners with patients and families to identify and prioritize needs and care.
  5. Keeps physicians, nursing staff and other members of the healthcare team informed of any changes to the discharge plan.  Relays information from insurance companies as related to lengths of stay and continued stay approval
  6. Provides payers with accurate, updated clinical information to secure continuing benefit coverage.  Assures that arranged discharged services or placement will be covered by the patient’s benefit plan.
  7. Acts as a liaison to link the patient with the most appropriate community or state resource.  Offers and explains options to the patient and family.
  8. Maintains current knowledge of available resources and services. Seeks assistance beyond local resources in difficult cases.
  9. Maintains client records and case notes and prepares and presents educational materials for client and/or family members.
  10. 10.Provides appropriate information to other agencies and individuals regarding client progress and participation.
  11. 11.Assists therapists in completing evaluations and assessments of intakes as needed.  12.Coordinates denied days appeal process with the medical staff, clinical information management and patient/family.
  12. .Maintains an active role in multi-disciplinary treatment team case reviews.  Assists Clinical Staff with intervention activities including educational and activity groups.
  13. Regularly documents in the electronic medical record, no less than once per day regarding discharge planning activities, patient response and participation, impediments to discharge, and strategies to overcome those impediments.
  14. Offers support and feedback to peers and staff. Applies principles of caring and healing in interactions with patients and families and with colleagues. 
  15. Performs other Duties as Assigned

 



What You Need to Be Successful:

  • Bachelor of Arts degree preferred in Behavioral Health Sciences or related field. 
  • Minimum of one (1) year experience in psychiatric or other health care setting. 
  • Behavioral Health experience may be substituted for educational requirement.

We are an Equal Opportunity/Affirmative Action employer.  All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law. 
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