Job Description

Location: St. Luke's Behavioral Health Center
Posted Date: 4/27/2023

About Steward Health Care
Nearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country’s largest physician-led, tax paying, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
Based in Dallas, Steward currently operates 39 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.
For more information, visit www.steward.org.

Position Description

• Validates the medical necessity of admission and ongoing services of patients at St. Luke’s Behavioral Health Center and verifies and obtains authorization from payor source.
• Utilizes InterQual criteria for admission and continued stay reviews.
• Continuously collects data about the behavioral healthcare status of the patient in a systematic way to determine the need and type of care and treatment to be provided, and the need for further assessment.
• Identifies various levels of treatment available for the patient and works closely with the multidisciplinary team to coordinate/evaluate continued care and services and also advocate for appropriate discharge planning (including next level of care). Obtains authorization for next level of treatment when appropriate.

Job Relationships:

Works with other departments as a team member. Is motivated to assist in ways of improving the Meds to Beds program.

Recognizes the dignity of each person and shows respect for one another. Works to resolve concerns and complaints promptly and effectively.

Maintains a collaborative relationship with all payors, hospital, medical and leadership staff.

Demonstrates an ability to be flexible, organized and function under stressful/emergency situations.

Communicates with physicians/director/charge nurse/co-workers, as appropriate about changes in patient’s clinical condition including results of assessment and treatment modalities.

Serves as a resource to all patients and health care team.

Authority:

To problem-solve patient care issues and initiate resolution through contact with chain of command.

Responsibilities/Essential Functions:

Follows all safety and infection prevention guidelines.

Implements hospital policies established by St. Luke’s Behavioral Health Center.

Keeps director and management apprised of administrative and clinical issues.

Demonstrates leadership skills oriented towards quality care delivered efficiently with appropriate utilization contributing to the overall smooth operation of the department and organization.

Participates in performance improvement activities.

Demonstrates an ability to be flexible, organized and function under stressful/emergency situations.

Performs related duties as directed by the Director of Case Management.

Reporting Requirements:

Reports to the Director of Case Management.

Minimum Education/Experience:

• Master’s degree preferred from an accredited University in behavioral health field with 2 years behavioral health experience. Bachelor’s Degree Required with 2 years behavioral health experience.
• Previous work in Utilization Management/Utilization Review working with Medicare and Medicaid payor sources is highly recommended. Certified Case Manager (CCM) and 2 years behavioral health experience is also acceptable.

Application Instructions

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