The Clinical Case Management Coordinator will be licensed as an LLBSW, LBSW, LLMSW, LMSW, LPC or MLP. (S)he will be responsible for ensuring that our residents and their external team are informed of programming, status and progress in habilitation at Eisenhower Center. In addition, will assist in disseminating feedback from the resident and external team to Eisenhower Center while developing and implementing action plans to address concerns. The Clinical Case Management Coordinator will also serve as a counselor, where necessary, for residents not on their clinical case management caseload.
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Role and Responsibilities
Case Coordination:
Schedule, facilitate and lead blue print meetings, IPOS meetings, team conferences and other clinical meetings
Training of habilitation staff on IPOS goals and any changes that may occur
Make weekly contact with residents to ensure that habilitation needs are being addressed.
Ensure compliance with documentation for all assigned residents
Ensure that all PCE requirements are met for service authorization
Facilitate appointments for residents for external medical needs
Maintain communication for all external and internal members of the resident's team (i.e. guardians, external case managers, conservators, etc..)
Discharge planning/coordination
Participate in the Lethality on Call (LOC) phone rotation
Counseling:
Administer and interpret basic assessment tools to evaluate levels of therapeutic need (by discipline and degree) at admission, discharge and other appropriate times within treatment and/or as requested by funding sources
Ensure that treatment recommendations are made based on assessment results, interpretations of scoring and medical necessity criteria
Individualize, design and implement effective counseling strategies/plans to meet client needs and goals
Service Requirements:
Provide services within discipline for 80% of monthly utilization
Maintain billing utilization requirement as set by Clinical Director
Documentation and Reporting:
Ensure that all documentation needs for billing are completed within 48-hours of service delivery of non PCE systems
Ensure that all documentation needs for billing in PCE systems within 24 hours of service delivery
Prepare daily service, monthly and quarterly progress reports ensuring that all insurance requirements regarding authorization and payment of services is completed within timely filing requirements and guidelines
Ensure that Medicaid requirements including but not limited to, IPOS, bio-psychosocial, residential assessments, etc are completed in a manner that ensures compliance and potential revenue generation
Ensure that the peer-to-peer or other authorization processes as required by varying funding sources is completed effectively to obtain authorization for services within timely filing requirements and guidelines
Ethics:
Demonstrate adherence to state practice acts and codes of ethical conduct in all spheres of clinical practice
Demonstrate knowledge and adherence to HIPAA policy and to work rules that incorporate disciplinary actions with the HIPAA regulations
Other Duties as Assigned:
All jobs include varying assignments as required by Eisenhower Center
Qualifications and Education Requirements
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Accepted License Levels: LLBSW, LBSW, LLMSW, LMSW, LPC or MLP
Eligible for credentialing with all major insurance funders as well as, Medicaid and Medicare
Skilled in the provision of evidence-based treatments
Valid driver's license
Preferred Skills
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Additional Notes
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Education
RequiredHigh School or better
PreferredBachelors or better
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Licenses & Certifications
RequiredDriver's License
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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