Case Manager
Recovery Centers of America, Devon, PA, United States
POSITION OVERVIEW
The Case Manager serves as a member of the treatment team by working closely with clinical, business development, admissions, nursing and other members of the multi‑disciplinary team. The Case Manager is responsible for facilitating recovery by addressing each patient’s individual needs and coordinating a thorough aftercare plan that will assist the patient to achieve the best possible outcomes through their recovery journey.
This includes collaborating with the patient to schedule a mutually agreed aftercare plan of care inclusive of PCP, SUD, MAT and other appointments as well as providing patients with community and other resources that will help ensure their success. The Case Manager serves as a patient advocate, coordinating care with internal and external providers, resources and supports.
The Case Manager engages each patient in their aftercare plan and using teach‑back method confirms that the patient and their support system understand the plan and the importance of adhering to it. The Case Manager serves as the liaison between the patient and all aftercare providers and resources, ensuring the plan has been established, communicated and confirmed prior to discharge.
The Case Manager will also assist patients with any identified outside issues, barriers to accessing care or external stressors that need to be resolved, enabling the patient to focus on treatment (examples: coordination with family for childcare, employer relations, legal concerns, etc.).
The Case Manager works collaboratively with the clinical team to engage, educate and coordinate patient care with the patient, their supports and all external providers to ensure a thorough aftercare plan.
The Case Manager also works closely with external constituents, providing a high level of customer service and satisfaction amongst everyone with whom they interact. Case Managers are responsible for fostering positive relationships between RCA and all stakeholders.
KEY RESPONSIBILITIES
Obtains applicable signed Release of Information (ROI) forms for all identified providers and resources in the Continued Care Plan (CCP) and other patient resources/supports (Employer/FMLA, Legal, Payer programs, Referral sources, Peer Support, etc.).
Completes a new patient admission assessment and documents it in Avatar within 72 hrs. of admission, obtaining patient history, needs and individual preferences to inform the patient’s treatment and aftercare plans.
Reviews the completed Biopsychosocial assessment to help identify all life‑domain needs and incorporates them into the CCP to ensure all identified patient needs are addressed during the stay and/or in the patient’s continuing care plan.
Documents at minimum a weekly progress note that includes patient progress toward discharge, discussions of discharge planning and recommended aftercare plan, actual or potential barriers to the plan and the patient’s engagement in their aftercare plan.
Initiates and documents all referrals specified in the CCP, including contact information, and confirms the aftercare plan addresses follow‑up for substance use, mental health, MAT, Social Determinants of Health and other identified life domains.
Participates in Multi‑Disciplinary Team (MDT) meetings and actively contributes to discussion regarding recommendations for each individual’s aftercare plan, discharge date, services and resources to be included in the aftercare plan and what is needed from other members of the team.
Schedules SUD/MAT appointments within 7 days of discharge and post‑discharge PCP follow‑up appointments when possible; all appointments and referrals must be documented in Avatar prior to the patient’s scheduled discharge.
Ensures effective and timely communication of relevant information to post‑discharge providers prior to discharge to facilitate a safe and thorough discharge plan.
Ensures the continued care/discharge plans are solidified 1 week prior to discharge and that a Transitions of Care meeting has been scheduled at least 7 days prior to discharge with the patient, the patient’s support system, and the therapist to review the recommended aftercare plan.
Confirms patient preferences and barriers to care have been identified and addressed in the plan, ensuring all dates, times, contact information, phone numbers, addresses, etc. are included in the CCP to help ensure patient’s adherence to the plan.
Assesses patient’s comprehension of the aftercare plan through verbal confirmation and verifies patient’s clear understanding of post‑discharge care instructions through teach‑back.
Follows referent protocols and provides timely clinical updates and other information as requested (with signed ROI).
Follows payer protocols and facilitates timely patient‑payer phone calls, referrals to payer peer‑support programs and provides other information as per contractual agreements.
Initiates and manages FMLA and Short‑term Disability applications as needed, with patient consent; coordinates with patients and their employers to facilitate benefit processes when applicable and documents all activities in the patient’s EMR.
Facilitates a weekly Aftercare/Next Steps group meeting for all new patients using a standardized RCA agenda and collateral; facilitates at least once weekly guesting to help prepare patients for their aftercare recovery plan and works closely with outpatient staff and alumni to inform the patient of RCA’s outpatient continuum and the benefits of continuity of care.
Conducts outreach phone calls to patients who leave treatment early or unplanned without a solid discharge plan to attempt to re‑engage patient in their recovery plan; calls occur within 24 hrs. when possible to connect them with an outpatient provider and appropriate resources.
MINIMUM QUALIFICATIONS AND SKILLS
Education:
High school diploma, GED or equivalent is required. A bachelor’s degree is preferred.
Experience:
At least one year of professional experience in the behavioral health and/or substance use treatment field is required. A combination of education and relevant experience will be considered.
Knowledge:
Must have a strong understanding of health care, the detoxification process, addiction and co‑occurring disorders, DSM and ASAM criteria and terminology.
Communication:
Written:
Ability to read, interpret and write clear, informative text and edit work for spelling and grammar.
Verbal:
Ability to speak clearly and persuasively, listen actively, respond well to questions and participate effectively in group presentations and team meetings.
Technical:
Proficiency in Microsoft Programs (Word, Excel, Outlook).
COMPETENCIES
Job Knowledge:
Understands duties and responsibilities of the Case Manager role, company mission/values, community resources, ability to network and form working relationships with community providers, willingness to engage in continuing education, and ability to use an electronic medical record.
Communication:
Excellent verbal and written communication skills, ability to deliver presentations clearly, share information and ideas with others, demonstrate good listening skills, and work directly with patients, families and community providers.
Critical Thinking and Problem Solving:
Demonstrates ability to analyze complex patient situations, develop appropriate post‑discharge care plans, evaluate consequences, and take decisive action based on thorough analysis and best practices in care transition management.
Time Management and Organizational Skills:
Excellent organizational and time‑management skills required to work with a variety of patients at various stages of life while adhering to all state and federal guidelines.
Decision Making:
Uses effective approaches for choosing a course of action, developing appropriate solutions and reaching conclusions; implements action plans consistent with available facts, resources and anticipated consequences; demonstrates confidence in managing challenging situations.
Collaboration:
Works collaboratively with other professionals and leaders across several disciplines, motivates the treatment team toward discharge planning, and obtains recommendations for ongoing treatment.
WORK ENVIRONMENT
This job operates in a professional office environment. The role routinely uses standard office equipment such as computers, phones, photocopiers and filing cabinets. The noise level in the work environment is usually moderate.
PHYSICAL DEMANDS
While performing the duties of this position, the employee is required to talk or hear regularly, use hands to handle or feel objects, tools or controls, stand, walk, sit, reach with hands and arms, and occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.
TRAVEL
Travel is primarily local during the business day, although some out‑of‑area and overnight travel may be required.
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The Case Manager serves as a member of the treatment team by working closely with clinical, business development, admissions, nursing and other members of the multi‑disciplinary team. The Case Manager is responsible for facilitating recovery by addressing each patient’s individual needs and coordinating a thorough aftercare plan that will assist the patient to achieve the best possible outcomes through their recovery journey.
This includes collaborating with the patient to schedule a mutually agreed aftercare plan of care inclusive of PCP, SUD, MAT and other appointments as well as providing patients with community and other resources that will help ensure their success. The Case Manager serves as a patient advocate, coordinating care with internal and external providers, resources and supports.
The Case Manager engages each patient in their aftercare plan and using teach‑back method confirms that the patient and their support system understand the plan and the importance of adhering to it. The Case Manager serves as the liaison between the patient and all aftercare providers and resources, ensuring the plan has been established, communicated and confirmed prior to discharge.
The Case Manager will also assist patients with any identified outside issues, barriers to accessing care or external stressors that need to be resolved, enabling the patient to focus on treatment (examples: coordination with family for childcare, employer relations, legal concerns, etc.).
The Case Manager works collaboratively with the clinical team to engage, educate and coordinate patient care with the patient, their supports and all external providers to ensure a thorough aftercare plan.
The Case Manager also works closely with external constituents, providing a high level of customer service and satisfaction amongst everyone with whom they interact. Case Managers are responsible for fostering positive relationships between RCA and all stakeholders.
KEY RESPONSIBILITIES
Obtains applicable signed Release of Information (ROI) forms for all identified providers and resources in the Continued Care Plan (CCP) and other patient resources/supports (Employer/FMLA, Legal, Payer programs, Referral sources, Peer Support, etc.).
Completes a new patient admission assessment and documents it in Avatar within 72 hrs. of admission, obtaining patient history, needs and individual preferences to inform the patient’s treatment and aftercare plans.
Reviews the completed Biopsychosocial assessment to help identify all life‑domain needs and incorporates them into the CCP to ensure all identified patient needs are addressed during the stay and/or in the patient’s continuing care plan.
Documents at minimum a weekly progress note that includes patient progress toward discharge, discussions of discharge planning and recommended aftercare plan, actual or potential barriers to the plan and the patient’s engagement in their aftercare plan.
Initiates and documents all referrals specified in the CCP, including contact information, and confirms the aftercare plan addresses follow‑up for substance use, mental health, MAT, Social Determinants of Health and other identified life domains.
Participates in Multi‑Disciplinary Team (MDT) meetings and actively contributes to discussion regarding recommendations for each individual’s aftercare plan, discharge date, services and resources to be included in the aftercare plan and what is needed from other members of the team.
Schedules SUD/MAT appointments within 7 days of discharge and post‑discharge PCP follow‑up appointments when possible; all appointments and referrals must be documented in Avatar prior to the patient’s scheduled discharge.
Ensures effective and timely communication of relevant information to post‑discharge providers prior to discharge to facilitate a safe and thorough discharge plan.
Ensures the continued care/discharge plans are solidified 1 week prior to discharge and that a Transitions of Care meeting has been scheduled at least 7 days prior to discharge with the patient, the patient’s support system, and the therapist to review the recommended aftercare plan.
Confirms patient preferences and barriers to care have been identified and addressed in the plan, ensuring all dates, times, contact information, phone numbers, addresses, etc. are included in the CCP to help ensure patient’s adherence to the plan.
Assesses patient’s comprehension of the aftercare plan through verbal confirmation and verifies patient’s clear understanding of post‑discharge care instructions through teach‑back.
Follows referent protocols and provides timely clinical updates and other information as requested (with signed ROI).
Follows payer protocols and facilitates timely patient‑payer phone calls, referrals to payer peer‑support programs and provides other information as per contractual agreements.
Initiates and manages FMLA and Short‑term Disability applications as needed, with patient consent; coordinates with patients and their employers to facilitate benefit processes when applicable and documents all activities in the patient’s EMR.
Facilitates a weekly Aftercare/Next Steps group meeting for all new patients using a standardized RCA agenda and collateral; facilitates at least once weekly guesting to help prepare patients for their aftercare recovery plan and works closely with outpatient staff and alumni to inform the patient of RCA’s outpatient continuum and the benefits of continuity of care.
Conducts outreach phone calls to patients who leave treatment early or unplanned without a solid discharge plan to attempt to re‑engage patient in their recovery plan; calls occur within 24 hrs. when possible to connect them with an outpatient provider and appropriate resources.
MINIMUM QUALIFICATIONS AND SKILLS
Education:
High school diploma, GED or equivalent is required. A bachelor’s degree is preferred.
Experience:
At least one year of professional experience in the behavioral health and/or substance use treatment field is required. A combination of education and relevant experience will be considered.
Knowledge:
Must have a strong understanding of health care, the detoxification process, addiction and co‑occurring disorders, DSM and ASAM criteria and terminology.
Communication:
Written:
Ability to read, interpret and write clear, informative text and edit work for spelling and grammar.
Verbal:
Ability to speak clearly and persuasively, listen actively, respond well to questions and participate effectively in group presentations and team meetings.
Technical:
Proficiency in Microsoft Programs (Word, Excel, Outlook).
COMPETENCIES
Job Knowledge:
Understands duties and responsibilities of the Case Manager role, company mission/values, community resources, ability to network and form working relationships with community providers, willingness to engage in continuing education, and ability to use an electronic medical record.
Communication:
Excellent verbal and written communication skills, ability to deliver presentations clearly, share information and ideas with others, demonstrate good listening skills, and work directly with patients, families and community providers.
Critical Thinking and Problem Solving:
Demonstrates ability to analyze complex patient situations, develop appropriate post‑discharge care plans, evaluate consequences, and take decisive action based on thorough analysis and best practices in care transition management.
Time Management and Organizational Skills:
Excellent organizational and time‑management skills required to work with a variety of patients at various stages of life while adhering to all state and federal guidelines.
Decision Making:
Uses effective approaches for choosing a course of action, developing appropriate solutions and reaching conclusions; implements action plans consistent with available facts, resources and anticipated consequences; demonstrates confidence in managing challenging situations.
Collaboration:
Works collaboratively with other professionals and leaders across several disciplines, motivates the treatment team toward discharge planning, and obtains recommendations for ongoing treatment.
WORK ENVIRONMENT
This job operates in a professional office environment. The role routinely uses standard office equipment such as computers, phones, photocopiers and filing cabinets. The noise level in the work environment is usually moderate.
PHYSICAL DEMANDS
While performing the duties of this position, the employee is required to talk or hear regularly, use hands to handle or feel objects, tools or controls, stand, walk, sit, reach with hands and arms, and occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.
TRAVEL
Travel is primarily local during the business day, although some out‑of‑area and overnight travel may be required.
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