Case Manager/Placement Specialist Per Diem

Company Summary

AdCare, a subsidiary of American Addiction Centers, Inc., is a for-profit substance abuse disorder treatment facility located at 107 Lincoln Street, Worcester, MA 01605 . For over 45 years, AdCare has been helping individuals and families struggling with alcohol and drug use, one life at a time. The AdCare name represents innovation, quality, and cost efficiency in treating alcohol and drug dependency. We are committed to improving the lives of our patients and their families by providing safe, effective, recovery-based alcohol and drug treatment.

Our addiction recovery center(s) provide a comprehensive approach to care. AdCare's integrated system of care offers a range of accessible treatment centers including a 114-bed inpatient hospital and several conveniently located outpatient sites located throughout the Massachusetts and Rhode Island areas. When you join AdCare, you become part of our family. AdCare seeks talented individuals who are passionate, empathetic, engaged in their work and dedicated to serving people. Together, we can enable our patients to live happier and healthier lives. Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit.

Job Summary:

This is a Per Diem Positon.  The primary function of the Case Manage/Placement is to ensure, through direct coordination, individualized quality treatment to patients at the most appropriate level of care that safely addresses the acuity of the patient through the expedient, cost effective application of services. Case Manager/Placement Specialist’s organize, manage, and review appropriate treatment from both Managed Care,  Utilization Review perspective and discharge planning. Ability to problem solve and coordinate treatment from a benefits perspective. Strong interpersonal skills. Familiarity with insurance benefits and national levels of criteria of care. Organized; directive; consistent. Ability to enter, document and analyze computer database systems.

Duties and Responsibilities: to include but not limited to the following: 

• Upon patient’s arrival and admission, conduct a case management interview with patient to determine if there is a need for FMLA, Short Term Disability Insurance and if there are any pending legal issues. Encourage patient to notify & involve family & significant other in treatment .
• Reviews and collates daily admission packets for the identification of insurance benefits, identification of patient expressed treatment issues, the verification of substances abused and history of prior treatment.
• Establishes and completes Patient Treatment Packet for each patient which includes the verification of Medical Staff's treatment diagnosis, treatment issues, treatment recommendations and tentative date of discharge to the next level of care as well as any unusual issues.
• Reviews on daily basis with Managed Care Companies proving vital clinical and treatment data that justifies LOC & LOS and gains authorization for such treatment. Maintains a working relationship with reviewers, is current with benefits structure and services and reports to 11:30am meeting or documents in logbook case review problems. Records authorization for insurance coverage in computer data base.
• Prepares Dr. to Dr. appeals, POCs, and chart appeals notifying Director of Care Coordination of outcomes. Documents such decisions on appropriate forms and adds to data base information in computer.
• Participates as a member of the Integrated Treatment Team on morning rounds and interfaces with each patient daily as appropriate.
• Communicate with the Attending Physician/Director of Care Coordination for appropriateness for admission and continued stay and with the Director of Care Coordination for "high risk” cases. Also completes Utilization Review sheets.
• Attend and participate in Clinical Review of Admissions and Discharge meetings.
• Attend and conduct the daily Treatment Planning Meeting with Counseling Staff.
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Education/Experience:

• Bachelor's Degree required. BA required with 3 years’ experience in Case Management/UR or Master’s in Counseling, Psychology or related field; MSW with 1-2 years’ experience in Case Management/UR.
• 2 years’ experience in the addictive illness, substance abuse, and/or recovery field is preferred.
• Two years of utilization review or substance abuse treatment planning or social services.
• Ability to read and interpret written information; write clearly and informatively; edits work for spelling and grammar. Ability to speak clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; and participates in meetings.
• Working knowledge of Microsoft Word, Excel, and Outlook.

AAC is committed to principles of equal opportunities for all employees.  The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws.