About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Position Summary:
Generates and accepts referrals, applies casework process, performs department duties, documents activities and performs functions of counseling, referral/resource acquisition/and case consultation and coordination.
Essential Functions and Responsibilities:
- Acts independently; consistently exercise discretion and judgment in performing work which is predominantly intellectual and varied in nature.
- Assists with program planning and development.
- Provides clinical on-call services if required.
- Maintains professional competency through continuing education.
- Completes client biopsychosocial assessments upon which an individualized plan of care with appropriate goals and interventions is developed.
- Utilizes DSM-V criteria to identify client diagnoses.
- Conducts one-to-one, group and conjoint counseling sessions as a vehicle to reaching stated goals and objectives.
- Communicates progress, prognosis and recommendations to referring agencies.
- Completes all required documentation in a timely and thorough manger.
- Completes and directs discharge summaries to referring agencies in a timely manner.
- Participates in staff meetings.
- Obtains, in a timely and independent manner, all required precertification and recertification of client visits. Communicates all precertification/recertification activity to appropriate supporting staff.
- Communicates with third party payers for precertification of admissions and continues stay days, providing required information to payers and documenting payer contacts and authorization details.
- Applies specified criteria to all patients requiring precertification to determine appropriateness of admission and level of care including observation status. Performs continued stay reviews utilizing approved criteria as indicated.
- Assists physicians and case managers to identify alternatives to admission for cases that do not require acute care.
- Conducts review of readmissions within specified time frame for same/similar diagnoses.
- Conducts reviews of one day stays for appropriate level of care/setting.
- Refers cases not meeting admission and/or level of care criteria to Physician Advisor.
- Documents as indicated in Utilization Management software program.
- Consults with other members of the multidisciplinary team, when appropriate.
- Coordinates and participates in denial management process.
- Maintains correspondence or records as necessary for reimbursement/third party review and PRO review and audits of same.
- Assumes responsibility for continuing education/professional development related to area of practice.
- Assists with admissions, discharges, transfer of patients, and concurrent paperwork as needed.
- Conducts didactic education sessions.
- Obtains necessary Release of Information forms.
- Knows, understands, incorporates and demonstrates the Vision, Mission and Values of McLaren Bay.
- Participates in performance improvement activities. Communicates with third party payers for precertification of admission(s) and continued stay days, providing required information to payers and documenting payer contacts and authorization details.
- Applies specified criteria to all patients requiring precertification to determine appropriateness of admission and level of care including observation status. Performs continued stay reviews utilizing approved criteria as indicated
- Assists physicians and case managers to identify alternatives to admission for cases that do not require acute care.
- Conducts reviews of one day stays for appropriate level of care/setting.
Documents as indicated in Utilization Management software program
- Coordinates and participates in denial management process.
- Provides for the age specific needs of the population served according to department standards, as evidence by observation, documentation and peer feedback.
( ) Newborn - Birth to discharge from McLaren Bay
( ) Infant - Any child up to one year
( ) Pediatric - One year to 12 years
( ) Adolescence - 13-17 years
(X) Adult - 18-64 years
(X) Geriatric - 65 years and older
- Performs other related duties as required and directed.
Department: Partial Hospitalization
Daily Work Times: Days
Scheduled Bi-weekly Hours: 80
Required for all therapists:
- Master’s Degree in Social Work, Psychology, Counseling or Nursing required.
- Licensure or certification in the State of
- Effective verbal and written communication skills with a diverse population.
- CPR issued by the American Heart Association or Red Cross Certification.
Required for therapist in Inpatient Substance Use Recovery Center:
- Minimum of two (2) years of clinical experience in substance use disorders treatment program.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
We are committed to encouraging and sustaining a work environment free of unlawful harassment, discrimination, and/or retaliation. We are an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s race, color, age, religion, sex/pregnancy (including pregnancy/childbirth or pregnancy/childbirth-related conditions), sexual orientation, gender identity, national origin, disability, veteran status, genetic information, or any other status prohibited by applicable laws. We also make good faith efforts to recruit, hire, and promote qualified women, minorities, individuals with disabilities, and veterans.
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
