About Job
- Plan, develop, assess, and evaluate care provided to members.
- Collaborate with primary care and specialist physicians to evaluate and develop baseline medical and psychosocial evaluations and individualized patient care/treatment plans.
- Recommend alternative levels of care and ensure compliance with federal, state, and local requirements.
- Develop and maintain case management policies and procedures.
- Coordinate care/services with utilization and/or quality reviewers and monitor level and quality of care.
- Coordinate the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
- Consult with internal and external physicians, health care providers, discharge planning, and outside agencies regarding continued care/treatment or hospitalization or referral to support services or placement.
- Arrange and monitor follow-up appointments.
- Encourage members to follow the prescribed course of care (e.g., drug therapy, physical therapy).
- Develop and collect data; trend utilization of health care resources.
- Interpret regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
Professional Field
Social Work
Other Behavioral, Mental, or Healthcare FieldPatient Focus
Diagnoses
Avoidant Personality Disorder
Therapeutic Approach
Methodologies
ECT
Pharmacotherapy
Modalities
Individuals
Practice Specifics
Settings
In-patient Non-Psychiatric
In-patient Psychiatric
Research Facilities/Labs/Clinical Trials
Home Health/In-home
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