Patient Navigator / Case Manager - Outpatient

JOB TITLE: Patient Navigator / Case Manager - Outpatient

POSITION SUMMARY:

WBI Outpatient & Telehealth Clinic provides intensive and targeted clinical therapeutic services to improve the continuum of care to our patients and to provide access to mental/behavioral healthcare services to the underserved. The Patient Navigator serves as first contact with our patients and their families and is responsible for completing the initial telehealth consult with patients and their families/guardians, assisting in case management functions, coordination of outpatient services, securing patient insurance and other payment processes, participating as a member of the treatment team, scheduling, and coordinating other patient management needs from intake to discharge. The Patient Navigator / Case Manager is responsible for providing accurate and timely communication, documentation, and problem-solving and recommendations to referral sources as well as the treatment team. Other duties as assigned.

WORKING CONDITIONS:

Duties require sitting, standing, walking regularly. Requires reaching overhead occasionally and lifting occasionally up to 25 lbs. Position requires that the individual be in good physical and mental health sufficient to support behavioral health patients of all ages. Patient Navigator / Case Manager must be able to maintain the ability to provide and support services through telehealth, including the need to speak and hear via teleconference. Hours may be irregular including evenings, duties variable. May be occasional occupational exposure to blood borne pathogens or other potentially infectious materials.

KNOWLEDGE, SKILLS AND EXPERIENCES REQUIRED:

Bachelor's degree in mental health/behavioral health or Social Sciences. Experience and willingness to provide services through telehealth is required. Two (2) years of experience in patient care and mental and behavioral health care or equivalent is preferred; demonstrated ability to successfully function in a case management capacity including ability to organize and enter data, complete reporting, organize patient files, communicate effectively through teleservices, and meet licensing and accreditation standards. Must have knowledge of developmental tasks of children, adolescent, adult and geriatric patients and apply knowledge in assessment and planning of care.

PERSONAL TRAITS, QUALITIES & APPTITUDES:

Demonstrates personal traits/behavior consistent with the values of Wyoming Behavioral Institute. Must be self-directed/self-motivated; must have good communication and interpersonal skills; must be flexible; must have good critical thinking/decision making skills and must have good understanding of systems and change processes. Must be able to: (1) perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; (2) accept responsibility for direction, control and planning of activity; (3) make evaluations and decisions based on measurable or verifiable criteria; (4) work independently; (5) recognize the rights and responsibilities of patient confidentiality; (6) convey empathy and compassion to those experiencing pain, physical or emotional distress, and/or grief; (7) relate to others in a manner which creates a sense of teamwork and cooperation; (8) communicate effectively with people from every socioeconomic, cultural, and educational background; (9) exhibit flexibility and cope effectively in an ever changing, fast-paced health care environment; (10) perform effectively when confronted with emergency, critical, unusual and/or dangerous situations; (11) demonstrate the quality work ethic of doing the right thing the right way; and (12) maintain a customer focus and strive to satisfy the customer's perceived needs.

DUTIES AND RESPONSIBILITIES:

Essential Functions:

• Meet with potential patients to discuss the benefits of outpatient services as a part of their continuum of care.
• Serve as support staff (milieu manager) for virtual IOP program.
• Track and organize all IOP referrals, admission/enrollment, and discharge needs.
• Recruit and register step-in patients for IOP and other outpatient services.
• Serve as intermediary between payer sources, patient/guardian, administrative coordinator, and utilization review.
• Actively participate in inpatient treatment team meetings, to support step down process to outpatient services.
• Provide stepdown groups in inpatient setting, to support connection with outpatient services.
• Ensure accurate and timely data entry for reporting purposes.
• Formulate patient file system and organization.
• Communicate on a regular and timely basis with relevant members of the treatment team and family members as appropriate.

Other Functions:

Interventions

• Provide case management services specific to patient eligibility, enrollment, and discharge.
• Participate in daily and weekly inpatient staffing meetings to coordinate step-down services for acute and residential patients.
• Serve as telemilieu manager as needed for group therapy and mental health intensive outpatient program.
• Assist in the development of strategies, goals, and objectives related to the step-down process.
• Relate to patients in an age-appropriate manner.
• Support scheduling for IOP and other outpatient services.
• Cross training with reception/front desk to support receptionist breaks and time off.

Data Collection/Entry/Organization

• Complete data entry for trending report purposes in multiple record/tracking platforms.
• Perform daily billing submission.
• Identify and communicate data driven trends in the step-down process.
• Ensure the collection and entry of data as it pertains to patient eligibility.
• Review & report on data and processes to outpatient team.
• Maintain communication as needed with county and state agencies.
• Uphold necessary documentation of all case management services and quality of care issues.
• Support physician/psychiatrist with documentation assistance and needs.
• Assist Utilization Review team with reviews and documentation for reviews.

Therapeutic Environment

• Contribute to the effective functioning of the assigned programs and facility-wide activities and services.
• Report unsafe conditions to appropriate personnel.
• Assure patient's rights are upheld.
• Ensure the safe and therapeutic functioning of the tele-milieu.
• Serve as Milieu Manager, as assigned.
• Create tele-therapy space to meet privacy standards and ensure safety of patients.
• Provides telehealth services that are comparable to in-person services.

Provider and/or Supervision of Care

• Collaborate effectively with physicians and other clinical disciplines in making decisions regarding each patient's need for care.
• Communicate with the treatment team and other providers to assure the continuity of care and expedite flow of services and transitions between levels of care.
• Intervene effectively in unusual and complex patient/family situations.
• Provide accurate safety support in crisis situations and participates in debriefing after crisis situations.
• Update and coordinate tele-therapy services to meet the needs of patients.
• Communicate effectively with patients, families, health care team members, and community providers regarding patient status and progress.
• Interact and communicate with community agencies in assessment of and service to patients in a timely manner.
• Provide liaison and referral services to community agencies and appear in court when requested or subpoenaed.
• Comply with required standards for medical/legal reporting situations (i.e., child abuse, dependent adult abuse, psychiatric commitment).
• Represent the facility at legal hearings as requested.
• Ensure that documentation meets policies, procedures, standards, and laws.