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Prime Healthcare

Acquires and reorganizes underperforming hospitals

Intake Case Manager - Social Work Services

Mental & Behavioral HealthPosted on Nov 11
Part-timeWoonsocket, RI, USANo salary listedIn-person

About the Job

Requirements

  • Maintains an active license as a Registered Nurse, Licensed Clinical Social Worker, or Licensed Independent Clinical Social Worker in Rhode Island.
  • Has at least five years of psychiatric experience.
  • Has knowledge of psychiatric medical necessity and case management regulations in discharge planning.

Responsibilities

  • Initiates triage of patients presenting to the Emergency Department in psychiatric emergency crisis and is responsible for the quality of emergency triage and appropriate resource management for patients presenting for emergent psychiatric assessment, triage, disposition, or crisis management.
  • Assesses psychiatric patients presenting to the Emergency Department or any acute care unit of the hospital.
  • Ensures patients presenting with potential psychiatric illness are appropriate for admission or disposition.
  • Ensures regulatory standards related to psychiatric admission are met and coordinates with the attending psychiatrist for appropriate admission orders.
  • Coordinates with community resources for appropriate disposition when the facility cannot meet the patient's care needs.
  • Manages the utilization review process related to triage and admission to the Behavioral Health Unit.
  • Advocates for patients, promotes cost containment, and integrates healthcare providers to support seamless care across the continuum.
  • Facilitates quality, clinical and cost effectiveness, and the use of evidence-based quality practices.
  • Ensures comprehensive admission and concurrent medical-record review for medical necessity, intensity of services, and severity of illness.
  • Provides oversight throughout patient admission and across the continuum, and supports interdisciplinary team members and discharge planning.

Desired Qualifications

  • Has more than two years of management experience.
  • Has experience in psychiatric emergency and triage.
  • Has knowledge of Milliman Criteria and InterQual Criteria.

About the Company

Prime Healthcare

Acquires and reorganizes underperforming hospitals

Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.

Company size
5,001-10,000
Company stage
Debt Financing
Total funding
$2.2B
Headquarters
Ontario, CA
Founded
2001

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