Job Description

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.

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

·         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

Additional Notes