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Case Manager Call Center - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Guaynabo, Puerto Rico |
About this job
FHC of PR, Inc. organization dedicated to increasing opportunities for psychiatric rehabilitation, over the last 17 years has become a trusted part of the mental health and substance abuse delivery system of the Island. Since we opened in 1996, we have joined with government agencies, health plans, other manage care organizations and the provider community to make treatment for mental illness and chemical dependency a reality for Puerto Ricans who would not otherwise have been able to receive care. FHCHS of Puerto Rico, Inc., is a subsidiary of Universal Health Services, Inc (UHS), that is the guarantor of all its subsidiaries. FHC provides high quality Mental Health and Employee Assistance Program. We are sensitive to the force that affects the global economy impacting the companies and the individuals in the same manner. We develop integrated solutions for health plans and employers in order to promote resiliency for workplaces, family members and individuals.
FHC currently has a Case Manager position available. The candidate selected will be responsible for the following:
The Case Manager of the Access Center is responsible for the depth of the clinical interventions with persons that require telephone counseling. Is responsible for crisis and emergency management and recommends the alternate care levels leading to a rehabilitation plan. Establishes direct communication with managers and representatives of the Access Center, with persons within FHC, clinics, and with the divisions of the integrated system to guarantee the continuity of care. Consults with psychiatrists the more complex cases. Offers support to the clinical work of the Access Center Represenatives and to all the efforts related to complying with the clinical criteria and handling the phone calls.
1. Offers psychological counseling through the phone to the persons who are referred
2. Offers intervention for psychiatric crisis or emergency management
3. Apply Care Enhancement Clinical Review Criteria.
4. Receives the previous shift
5. Provides follow-up to all emergency calls
6. Identifies the most appropriate level of care and counsels and informs the person about the various options of service available for his or her rehabilitation
7. Refer and analyzes with the psychiatrist special situations that require medical or clinical confirmation regarding the correctness of the final decision taken
8. Consults with the psychiatrist matters related to the management of medications to make certain and validate the counseling that is going to be provided
9. Authorizes the services of an ambulance in harmony with the existing criteria guide
10. Establishes direct communication with the physicians of the physical facilities that require clarification about the clinical decision taken
11. Facilitates the access of the person to the services for his or her rehabilitation and authorizes the necessary visits for the continuation of treatment.
12. Makes and logs the follow-up call for crisis or emergency cases 24 hours after the coordination of services to assure the continuity of care
13. Logs and generates the authorization of services in the PMHS application within 24 hours.
14. Delivers the cases that require follow-up to the case manager of the next shift following the standards and makes sure that the previous shift cases are received complete and appropriately
15. Identifies persons of early or recurrent readmission to a hospital to offer the suitable follow-up
16. Identifies beneficiaries with high services utilizations and refer them to the Case Management Program.
17. Discuss complex cases with Utilization Review and Case Management Departmnets
18. Keeps the specialization license and professional association membership (colegiacioacuten) effective
19. Complies with the continuing education hours that corresponds to the specialization
20. Responsible for meeting daily with the representatives assing to his/her shift to establish the work strategies
21. Provides leadership in clinical decisions for the public as well as the private sector
22. Offers direct support to representatives by sharing the pending caseload
23. Available for case analysis and for clinical decision-making
24. Supports the Access Center service representative in the management of logistic issues that require a more extensive intervention, such as: problems with transportation, coordination with facilities, among others.
25. Complies with the standards of the Service Excellence Program.
Minimum qualifications:
Education: Master's in Social Work, Psychology, Psychological Counseling, Mental Health Counseling, or Psychiatric Nursing
Licenses: Valid and current active license for Social Work, Psychiatric Nursing, Psychological Counseling, Psychology, or Mental Health counseling
Professional associating membership (colegiacioacuten): Valid membership for Social Work and Psychiatric Nursing
Relevant Work Experience: Two or more years of experience in the health field
159713
FHC currently has a Case Manager position available. The candidate selected will be responsible for the following:
The Case Manager of the Access Center is responsible for the depth of the clinical interventions with persons that require telephone counseling. Is responsible for crisis and emergency management and recommends the alternate care levels leading to a rehabilitation plan. Establishes direct communication with managers and representatives of the Access Center, with persons within FHC, clinics, and with the divisions of the integrated system to guarantee the continuity of care. Consults with psychiatrists the more complex cases. Offers support to the clinical work of the Access Center Represenatives and to all the efforts related to complying with the clinical criteria and handling the phone calls.
1. Offers psychological counseling through the phone to the persons who are referred
2. Offers intervention for psychiatric crisis or emergency management
3. Apply Care Enhancement Clinical Review Criteria.
4. Receives the previous shift
5. Provides follow-up to all emergency calls
6. Identifies the most appropriate level of care and counsels and informs the person about the various options of service available for his or her rehabilitation
7. Refer and analyzes with the psychiatrist special situations that require medical or clinical confirmation regarding the correctness of the final decision taken
8. Consults with the psychiatrist matters related to the management of medications to make certain and validate the counseling that is going to be provided
9. Authorizes the services of an ambulance in harmony with the existing criteria guide
10. Establishes direct communication with the physicians of the physical facilities that require clarification about the clinical decision taken
11. Facilitates the access of the person to the services for his or her rehabilitation and authorizes the necessary visits for the continuation of treatment.
12. Makes and logs the follow-up call for crisis or emergency cases 24 hours after the coordination of services to assure the continuity of care
13. Logs and generates the authorization of services in the PMHS application within 24 hours.
14. Delivers the cases that require follow-up to the case manager of the next shift following the standards and makes sure that the previous shift cases are received complete and appropriately
15. Identifies persons of early or recurrent readmission to a hospital to offer the suitable follow-up
16. Identifies beneficiaries with high services utilizations and refer them to the Case Management Program.
17. Discuss complex cases with Utilization Review and Case Management Departmnets
18. Keeps the specialization license and professional association membership (colegiacioacuten) effective
19. Complies with the continuing education hours that corresponds to the specialization
20. Responsible for meeting daily with the representatives assing to his/her shift to establish the work strategies
21. Provides leadership in clinical decisions for the public as well as the private sector
22. Offers direct support to representatives by sharing the pending caseload
23. Available for case analysis and for clinical decision-making
24. Supports the Access Center service representative in the management of logistic issues that require a more extensive intervention, such as: problems with transportation, coordination with facilities, among others.
25. Complies with the standards of the Service Excellence Program.
Minimum qualifications:
Education: Master's in Social Work, Psychology, Psychological Counseling, Mental Health Counseling, or Psychiatric Nursing
Licenses: Valid and current active license for Social Work, Psychiatric Nursing, Psychological Counseling, Psychology, or Mental Health counseling
Professional associating membership (colegiacioacuten): Valid membership for Social Work and Psychiatric Nursing
Relevant Work Experience: Two or more years of experience in the health field
159713