Case Manager - Mental Health Services jobs in Carson City, NV

Case Manager - Mental Health Services coordinates the overall plan of care for patients with mild to moderate emotional and behavioral problems. Oversees patient evaluation and treatment planning, and monitors patient progress, adjusting treatment plans as necessary. Being a Case Manager - Mental Health Services acts as a liaison between patient/family and service delivery personnel to ensure patients are being effectively treated. Typically requires a master's degree in social work or equivalent. Additionally, Case Manager - Mental Health Services typically requires a State License to Practice Clinical Social Work. Typically reports to a head of a unit/department. The Case Manager - Mental Health Services occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Case Manager - Mental Health Services typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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REMOTE UTILIZATION REVIEW CASE MANAGER
  • Carson Tahoe Health
  • Carson, NV FULL_TIME
  • Description

    US:NV:Carson City Integrated Care Management

    Per Diem Day Shift

    About Carson Tahoe Health

    CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.

    Summary

    This position is responsible for facilitating care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources while respecting patient’s right to self-determination. This position has the overall responsibility to maintain current knowledge of disease processes, available resources, treatment options appropriate to patient population and reviewing medical necessity, responding to authorization concerns, and/or reconciling coverage related issues. This position collaborates with medical staff, interdisciplinary team, and external resources to screen for accurate medical necessity and appeal appropriate accounts according to internal guidelines.

    Responsibilities

    • Transition management – Assigns appropriate length of stay, participates in readmission prevention, transition level of care and patient satisfaction 
    • Utilization management – Screens for accurate medical necessity using approved evidenced based criteria, application of supporting medical necessity and denial prevention utilizing physician advisor when necessary
      • Reviews clinical denials and initiates process, if determined appeal appropriate according to internal guidelines 
    • Clinical Appeals - Responsible for drafting, finalizing, and sending clinical appeal letters in order to reverse a denial for payment on an insurance claim 
      • Uses provided tools and patient medical records, working within and through the regulations to develop a documented response to the denial and overturn the payer's decision 
      • Stays current with assigned accounts and follow-up on the appeal after submission to determine next steps to ensure appeals are overturned or upheld 
      • Responsible for appealing denials using clinical based rationale, the need to produce high quality work with meeting compliance timeframes and production goals 
      • Supports billing and authorization coordination staff in reviewing high-risk and high-dollar accounts before claim submission to prevent clinical denial 
      • Works in partnership with Integrated Care Management Authorization Coordinators and Admin Staff 
      • Assists staff in care coordination and demonstrating efficient throughput while assuring care is sequenced and at appropriate level of care 
      • Accurately conducts a thorough, objective assessment of patient’s current status, including psychosocial, physical, financial, educational needs, treatment course and services needed 
      • Compliance with state and federal regulations, The Joint Commission’s standards, Center for Improvement in Healthcare Quality (CIHQ), Conditions of Participation and hospital policy 
      • Maintains current knowledge of disease processes, available resources, and treatment options appropriate to patient population 
      • Collaborates with interdisciplinary team to promote patient throughput and efficient use of resources 
      • Continuously demonstrates a positive attitude and understanding of case management philosophy, supports team building, and is motivated to fulfill department objectives 
    • Utilizes Evidence -based clinical guideline tool (Milliman Care Guidelines ® or InterQual ®) 
      • Documents all activity according to policy, including the electronic automated systems 
      • Precepts new staff members and is a resource to all staff 
    • Participates in department quality improvement initiatives and projects as assigned 
    • Ability to perform role remotely and maintain collaboration with interdisciplinary team 
    • Performs other related duties as assigned

    Qualifications

    Required 

    • Minimum (2) years of acute care hospital patient care experience  
    • Current unrestricted registered nurse license in the State of Nevada 
    • Organizational skills, excellent verbal & written communication skills, ability to lead, coordinate diverse group in fast paced environment, critical thinking, problem solving and negotiation skills 
    Preferred 
    • Two (2) years of experience as acute care case manager 
    • Bachelor of Science in Nursing 
    • Ability to obtain Accredited Case Manager (ACM) certification

    Top 5 Reasons to Live in Carson City, Nevada

    • Live, work and play in one of the most beautiful regions in the world
    • Enjoy an array of outdoor activities world class skiing, golf, camping, mountain biking, hiking, water skiing, kayaking, hunting and fishing
    • Just next door is Beautiful Lake Tahoe
    • We are minutes from Reno known as the 'biggest little city in the world' - Fine dining, nightlife, shopping and home to the University of Nevada Reno.
    • Family friendly atmosphere with affordable housing & excellent school system

    Our Benefits

    • No State Income Tax
    • Medical, Dental, Vision, FSA, Telehealth
    • Paid Time Off, Mental Health, and Volunteer Days
    • 100% Vested 401K & Roth with Company Contribution
    • Tuition Reimbursement
    • Referral Bonuses
    • On Site Education & Certification Programs
    • Base Wage Increases for Relevant Advanced Degrees
    • Free Calm App Subscription
  • 1 Day Ago

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Registered Nurse Case Manager (RNCM) – Home Health
  • Mission Healthcare
  • Carson, NV FULL_TIME
  • Be part of providing an exceptional patient experience.About Us:Healthy Living at Home is a leading home healthcare provider committed to delivering high-quality, compassionate care to our patients. W...
  • 13 Days Ago

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MENTAL HEALTH TECH I
  • Carson Tahoe Health
  • Carson, NV FULL_TIME
  • DescriptionUS:NV:Carson City BHS Mallory Crisis CenterPart Time Variable ShiftAbout Carson Tahoe HealthCTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by ...
  • 24 Days Ago

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MANAGER BHS CLINICAL SERVICES
  • Carson Tahoe Health
  • Carson, NV FULL_TIME
  • DescriptionCarson City, NV | Full Time US:NV:Carson City BHS AdministrationAbout Carson Tahoe HealthCTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the...
  • 22 Days Ago

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Program Director
  • Mental Health Matchmakers
  • Yerington, NV FULL_TIME
  • We’re looking for a Deputy Program Director at our adolescent Residential Treatment Program in Yerington, NV. What you’ll do: The Deputy Program Director will oversee residential services and living u...
  • 8 Days Ago

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CLINICAL PROGRAM MANAGER 1, OPTION C: MENTAL HEALTH
  • State of Nevada
  • Silver Springs, NV FULL_TIME
  • State of Nevada Announces An Open Competitive Recruitment for: CLINICAL PROGRAM MANAGER 1, OPTION C: MENTAL HEALTH APPROXIMATE ANNUAL SALARY - $69,008.40 to $103,335.12 PAY GRADE: 39 For more informat...
  • 18 Days Ago

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0 Case Manager - Mental Health Services jobs found in Carson City, NV area

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Clerk Processor I
  • GOODWILL INDUSTRIES SACRAMENTO VALLEY & NORTHERN NEVADA INC
  • Carson City, NV
  • Job Details Level Entry Job Location Carson City - CARSON CITY, NV Position Type Full-Time/Part-Time Salary Range $17.00...
  • 3/28/2024 12:00:00 AM

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Postal Clerk
  • The Postal Service
  • Carson City, NV
  • POSTAL CLERK NO EXPERIENCE REQUIRED PAID TRAINING PROVIDED JOB SECURITY The Postal Service is the largest government rel...
  • 3/28/2024 12:00:00 AM

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Postal Mail Processor
  • The Postal Service
  • Carson City, NV
  • POSTAL CLERK NO EXPERIENCE REQUIRED PAID TRAINING PROVIDED JOB SECURITY The Postal Service is the largest government rel...
  • 3/28/2024 12:00:00 AM

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Retail Sales Associate (Part-Time)
  • AutoZone, Inc.
  • Carson City, NV
  • AutoZone's Part-Time Retail Sales Associates drive sales through superior customer service by exceeding customer expecta...
  • 3/28/2024 12:00:00 AM

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Senior Data Scientist (Remote Consideration)
  • Careerbuilder
  • Carson City, NV
  • Alternate Locations: Radnor, PA (Pennsylvania); Charlotte, NC (North Carolina); Fort Wayne, IN (Indiana); Hartford, CT (...
  • 3/28/2024 12:00:00 AM

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Licensed Practical Nurse (LPN)
  • Prestige Care, Inc.
  • Carson City, NV
  • What does the Licensed Practical Nurse do?: Ever wanted to work in an environment where you get to know your patients (w...
  • 3/28/2024 12:00:00 AM

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Field Based Community Health Worker
  • UnitedHealthcare
  • Carson City, NV
  • At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers t...
  • 3/27/2024 12:00:00 AM

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Housekeeper
  • Healthcare Services Group, Inc.
  • CARSON CITY, NV
  • Overview: Who We Are Healthcare Services Group (HCSG) is an experienced partner managing housekeeping, laundry, dining, ...
  • 3/4/2024 12:00:00 AM

Carson City is an independent city and capital of the US state of Nevada, named after the mountain man Kit Carson. As of the 2010 census, the population was 55,274. The majority of the town's population lives in Eagle Valley, on the eastern edge of the Carson Range, a branch of the Sierra Nevada, about 30 miles (50 km) south of Reno. The town began as a stopover for California-bound emigrants, but developed into a city with the Comstock Lode, a silver strike in the mountains to the northeast. The city has served as Nevada's capital since statehood in 1864; for much of its history it was a hub ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Case Manager - Mental Health Services jobs
$71,076 to $86,644
Carson City, Nevada area prices
were up 2.5% from a year ago

Case Manager - Mental Health Services in New Orleans, LA
Before it is even time to leave the hospital, the Hospital Liaison will meet with you to help plan for your transition back into your community.  This worker’s objective is to assist you with making that process as seamless as possible in the location of your choice.  Following discharge, you’ll receive ongoing support and advocacy as you’re connected with services that are beneficial to your overall health.
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Case Manager - Mental Health Services in Lancaster, PA
Case Management services help people with long-term behavioral health problems to.
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Case Manager - Mental Health Services in Des Moines, IA
This program provides the same objectives and services as the MHICM program in Danville serving our mentally ill Veterans who struggle to remain independent in the community.
January 09, 2020