Collaborates with physicians, case managers, nursing department personnel, third party payors and other customers for admission to appropriate level of care throughout the continuum.
Assess patients to determine medical necessity and appropriate level of care with admissions based upon approved criteria. Discuss all cases not meeting medical necessity or approved criteria with the Staff RN – Intake Coordinator, physician and/or other licensed Mental Health Therapist and obtain approval prior to disposition.
Collaborate with the admitting physician, unit staff and case managers, as necessary, to determine appropriateness of admission or level of care. Completes all necessary paperwork to insure the admission is clinically appropriate, to include insurance authorizations for treatments.
Assist patients in understanding insurance questions/issues related to their financial responsibility associated with treatment.
Have a thorough understanding of EMTALA and abide by its regulations.
Provide feedback to admitting physician and case management in reference to self-paid admissions in a timely manner.
Have a complete understanding of all insurance companies that St Anthony is a provider for. Demonstrate an understanding and knowledge of in and out of network contracts.
Understand and utilize physician rotation list.
Perform telephone crisis intervention services and provide appropriate resources and/or referrals as needed.
Provide mental health assessments and consults to Med/Surg floor and Emergency Room as needed and in a timely manner.
Demonstrate the ability to make highly competent professional judgments and decisions. Utilize critical thinking skills and CQI philosophy and tools for problem-solving or process design. Serve as a resource and hospital liaison to patient/families, physicians, members of the health care team, and external organizations with regard to the case management program, available health care resources, appropriate level of care and financial issues.
Must be 21 years of age.
Current licensure as a Licensed Professional Counselor (LPC), Licensed Marital/Family Therapist (LMFT), Licensed Behavioral Practitioner (LBP), or Licensed Clinical Social Worker (LCSW).
Bachelor of Science in Nursing.
About SSM St. Anthony's Hospital
St. Anthony Hospital is a 601-bed regional referral facility specializing in cardiology, oncology, surgery and behavioral medicine. The hospital, established in 1898, is located in Midtown Oklahoma City and serves the needs of Central Oklahoma, as well as many counties throughout Oklahoma, through its large rural affiliate network of hospitals. Four St. Anthony Healthplex campuses provide convenient emergency and outpatient service access to the outlying communities of the metropolitan area. St. Anthony added urgent care services in May 2015 at St. Anthony North. St. Anthony has received numerous awards including the Oklahoma Quality Award for Excellence, Certified Healthy Business, Premier QUEST® Award for High-value Healthcare Citation of Merit, among others. Healthsights ranks St. Anthony at performance levels for quality and patient satisfaction higher than local competitors and many national health care organizations.
Internal Number: 17002656
About SSM Health
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your family and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same