Full Job Description
How You'll Make a Difference:
Performs case management for contracted clients who are receiving service in all levels of behavioral health care.
Assesses and reviews cases for medical necessity based on established behavior health criteria.
Authorizes treatment based on appropriate modality and level of care. Determines how many sessions to authorize for treatment and makes recommendations for other types of care. Monitors and coordinates the care plan through concurrent review with providers, retrospective chart review and prospective review of client's treatment plan.
Using effective and service-oriented presentation style, develops and maintains collaborative working relationships with providers and others involved in the delivery of care to clients.
Participates in clinical and administrative meetings to promote quality, cost-effective treatment outcomes as needed.
Accurately records all contracts and clinical information in client records in the computer record within established time frames.
Provides clinical backup for other Care Coordinators and after hours coverage.
Reviews all high-risk cases, complaints, denials and grievances with Manager, Clinical Services.
Coordinates and implements case management referrals by communicating directly with physicians, families, vendors, third party administrators (TPA's), medical directors, Utilization Management staff, hospital staff and other appropriate ancillary providers on a regular basis.
Provides care to patients with multi-diagnoses in medical and psychiatric conditions.
In collaboration with the Clinical Services Manager, coordinates all aspects of affiliate development including the identification of EAP Affiliate Providers and the negotiation, implementation and on-going management of the EAP Affiliate Network.
What it Will Take:
Licenses & Certifications
Registered Nurse license issued by the state of WI, or
Marriage and Family Therapist license issued by the state of Wisconsin, or
Professional Counselor license issued by the state of Wisconsin, or
Social Worker license issued by the state of Wisconsin.
Bachelor's Degree Nursing, Behavioral Sciences or related field.
Required Functional Experience
Typically requires 2 years of experience in case management, utilization review and discharge planning.
Knowledge, Skills & Abilities
Training and experience in a broad range of mental health and substance abuse treatment in an inpatient or outpatient facility. Strong interpersonal and communication skills. Self-motivated and good problem solving skills. Ability to complete requirements of agency and program/department orientation.
Monday-Friday, No Holidays, No Weekends.
Flexible hours between 7am-6pm.
Population Health Services
12500 W Bluemound Rd
Elm Grove, WI
At Aurora Health Care:
We pride ourselves on taking care of our people. And not just our patients—we mean you, too. We help each other live well. When you work at Aurora, you get the chance to work with a dedicated team that’s as passionate about the work as you are. Here, you’ll find limitless opportunities for ongoing learning, career advancement, competitive compensation and a stable work environment. But more than that, you have the opportunity to change lives—including your own.
Diversity and inclusion matters at Aurora. We celebrate our differences and nurture an environment where everyone feels included. We know that when we reflect the communities we serve, when we embrace differences and bring our whole selves to work every day, we are working as one to build a healthier tomorrow for everyone. Aurora supports a safe, healthy and drug-free work environment through criminal background checks and pre-employment drug testing. We maintain a smoke-free environment at all our locations. We are an equal opportunity employer.