What are the responsibilities and job description for the BEHAVIORAL HEALTH CARE MGR-Case Management position at Westchester Medical Center?
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Job Summary |
- The Behavioral Health Care Manager supports the inpatient programs by implementation or investigation of the procedures in the Utilization Review and Discharge Planning program at Westchester Medical Center. In addition, the Behavioral Health Care Manager monitors length of stay and resource consumption of patients; evaluates, investigates and reports on hospital incidents; assists with developing procedures to improve patient care and meet the medical standards for patient care prescribed by accrediting, licensing and reimbursement agencies.
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Responsibilities |
- Screens patient's charts concurrently and/or retrospectively, using approved screening criteria for Quality Management and Utilization issues, to ensure that Westchester Medical Center is in compliance with required standards.
- Identifies quality care issues which have the potential for impact on the process and outcome of the treatment of patients.
- Confers with the treatment team members, if indicated, when occurrences are identified and assists in the development of corrective action.
- Facilitates the peer review function by initiating the trending process.
- Reviews daily census and forwards abstracts to appropriate coordinator to ensure ongoing review of patient care.
- Participates in daily multi-disciplinary team meetings
- Completes PRI for patients being discharged to Nursing Homes, Adult Homes, or Rehabilitation Facilities.
- Ensures patient is progressing towards desired outcomes by continuously monitoring patient care assessments and/or evaluations.
- Implements the Discharge Review Program mandated by New York State Department of Health to facilitate issuance of IMM's and discharge notice to patients.
- Uses computer applications or other automated systems such as spreadsheets, word processing, calendar, e-mail and database software in performing work assignments.
- Accesses Protected Health Information (PHI) in accordance with departmental assignments and guidelines defining levels of access (i.e. incidental vs. extensive).
- Performs other related duties as assigned.
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Qualifications/Requirements |
- Experience:
- Minimum of 3-5 years experience in Acute Behavioral Health clinical specialty.
- Three years of experience where the primary function of the position was nursing in a hospital or health care agency, one year of which must have been at a leadership level, and one year of which must have been in either a hospital, health care agency or managed care company in the area of utilization review, quality assurance, risk management or discharge planning.
Education:- Graduation from an accredited school of nursing with a Baccalaureate Degree preferred.
- Substitution: Satisfactory completion of 30 credits at a recognized college or university in a Bachelor's or Master's Degree. Nursing program may be substituted for one year of the general nursing experience above.
Licenses/Certifications:- Possession of a valid license and current registration, issued by the New York State Department of Education as a Registered Professional Nurse
Other:- If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.
- Thorough knowledge of application of current nursing techniques and procedures, the New York State Nurse Practice Act, regulatory agency standards, Centers for Medicare & Medicaid Services, Office of Mental Health and Det Norske Veritas (DNV) standards.
- Ability to review, analyze and investigate Quality Assurance standards of patient care and identify deficiencies; collaborate with other areas of hospital operations and administration; communicate effectively both orally and written; set priorities and effectively use computer applications.
- Ability to read, write, speak, understand and communicate English sufficiently to perform the essential duties of the position, initiative; profession competence; sound judgment.
