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Outpatient Case Manager - Pediatrics Clinic (Full Time)

Company: Benefis Health System
Location: Great Falls
Posted on: February 13, 2020

Job Description:

Responsible for the coordination and implementation of case management activities for outpatient Pediatric Behavioral Health Services. Works with all members of the healthcare team to assure a collaborative approach is maintained in care and treatment of the patient. Reviews care and treatment for appropriateness against screening and reimbursement criteria. Plans and coordinates home care services and needs. FLSA: NON-EXEMPT DUTIES AND RESPONSIBILITIES: Provide a comprehensive strengths-based assessment for assigned children and family coordinating with the interdisciplinary team. Develop crisis plan based on recommendation of clinician Provide outreach and follow-up for individuals who drop out of treatment Provide consultation and education services to outside agencies that work with people that may have mental illnesses Possesses advanced knowledge of Medicare and Medicaid and other third-party reimbursement methodology, procedures, coding and requirements. Maintains and keeps current reimbursement documentation in collaboration with the business office. Maintains current knowledge of third-party reimbursement and guidelines, maintains current knowledge of all payers. Consults with physicians and therapists for continuity of care and collection of clinical data when necessary to ensure maximum charge capture, billing and collections. Maintains current knowledge of reimbursement practices, medical record practices and the standards and regulations of CMS, JCAHO and other regulatory agencies. Orders and arranges for home care equipment, healthcare needs. Works with third party payers to validate need for patient care and home care environment needs. Completes documentation necessary for third party reimbursement. Demonstrates an ability to be flexible, organized and function under stressful situations. Maintains a good working relationship both within the department and with other departments. Consults other departments, as appropriate, to collaborate in patient care. Functions as a patient/family advocate. Provide in community support through home, community and school visits. Documentation meets current standards and policies. Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict. Demonstrates ability to perform job specific competencies (refer to skills checklist). Assist child and family in maintaining of culturally appropriate basic living needs, including but no limited to housing, food, medical care and recreation. Professional Requirements: Adheres to dress code. Completes annual educational requirements. Maintains regulatory requirements. Wears identification while on duty. Maintains confidentiality at all times. Attends department staff meetings as required within the department. Reports to work on time and as scheduled; completes work in designated time. Represents the organization in a positive and professional manner. Actively participates in performance improvement and continuous quality improvement (CQI) activities. Coordinates efforts in meeting regulatory compliance, federal, state and local regulations and standards Communicates and complies with the Benefis Health System Mission, Vision and Values as well as the focus statement of the department. Complies with Benefis Health System Organization Policies and Procedures. Complies with Health and Safety Standards and Guidelines. Education/Experience Requirements: Bachelor's degree in human services field One year experience serving people with mental illnesses or individuals with other educational backgrounds who, as providers, consumers or advocates of mental health services have developed the necessary knowledge and skills (graduation from high school or GED and a combination of relevant experience and/or education equaling at least four years). TFCBT licensed clinician preferred or willing to be trained in sanctuary model or other trauma schema Community Information Great Falls has a city population of 60,000, with a draw of over 275,000 people in north central Montana. We experience mild winters and enjoy blue skies over 300 days per year. Great Falls is a wonderful and safe place to raise a family, with nationally ranked public schools and an average commute of under 12 minutes, making the quality of life in Great Falls unsurpassed in the Rocky Mountain West. Additionally, the Missouri River, a blue-ribbon fly-fishing destination, runs through the middle of town. Outdoor activities include camping, hiking, horseback riding, water and snow skiing, rock and ice climbing, boating, whitewater kayaking, off-road motorsports, upland bird and waterfowl hunting, and big-game hunting. Benefis Health System This is your opportunity to be part of an exceptional health system in a state that is well known for its beautiful four seasons and outdoor lifestyle. While enjoying the last best place, you'll have the added benefit of having access to Benefis Health System, one of the state's most modern and progressive healthcare facilities with 500+ beds and over 270 employed medical staff members representing more than 40 specialties. Our state-of-the-art facilities and cutting-edge technologies make Benefis an exceptional working environment.

Keywords: Benefis Health System, Great Falls , Outpatient Case Manager - Pediatrics Clinic (Full Time), Executive , Great Falls, Montana

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