Working for healthcare facilities the clinical care managers are in charge of running the organization smoothly. The essential roles and responsibilities of a clinical care manager are handling operational tasks, supervising and directing the staff, assigning budgets, taking purchasing decisions, organizing meetings, implementing directives, managing clinical staff, overseeing daily operations, handling communications, assigning cases to staff and managing the recruitment processes.
The professionals willing to work as clinical care managers should demonstrate solid medical management skill, computer operation abilities, teamwork, time management, excellent knowledge of standards and regulations of clinical care, proficiency in patient management software and an aptitude to solve conflicts and issues. A well-demonstrated Clinical Care Manager Resume makes a mention of a bachelor’s degree in medical service administration or the like.
Objective : Trained in Implementing a Strength Based Approach in the treatment of Co-Occurring Mental Health and Substance Abuse Disorders, through UMBC. Demonstrated talent for directing and supervising staff, achieving balance between task needs and employee needs.
Skills : Microsoft Office, Care Assistant.
Description :
Responsible in coordinating care to assigned clients, establishing a goal directed care plan from admission to discharge which includes a comprehensive ongoing assessment of clients' needs.
Performed on site supervisory visits to assess client, family, environment, and clinical care givers and complete follow-up documentation.
Ensured availability and proper operation of necessary equipment and supplies related to patient care.
Promoted and managed expectations and satisfaction with patients and family members.
Evaluated the quality and effectiveness of nurse practice and nursing services, analyzing appropriate data and information in order to improve services and patient outcomes.
Provided nursing updates and approval for private duty nursing, obtain re-authorization for care and ongoing supervision, orientation, training, education, and evaluation of clinical field staff.
Performed medical necessity audits of requests for mental health services.
Engaged members into various chronic disease management programs.
Experience
2-5 Years
Level
Junior
Education
Nursing
Sr. Clinical Care Manager Resume
Summary : Experienced mental health therapist providing counseling to adolescents and adults suffering with addictions, anxiety, depression, and personality disorders. Skilled in clinically managing appropriate levels of care for behavioral health and substance abuse cases.
Skills : Outpatient Therapy, Assessment And Diagnosis, Case Management, Treatment Planning And Implementation.
Description :
Providing behavioral health assessments and referrals in the scope of the Employee Assistance Program, through timely and efficient evaluation of the mental and physical condition of clients while assessing immediate risk and safety.
Educated clients about mental illness, substance abuse, domestic violence, medication, and available community resources.
Provided clinical support telephonically using established triage methods.
Assisted clients in connecting to behavioral healthcare professionals in their area, including emergent assistance when appropriate.
Created and maintained accurate records electronically for each occurrence.
Oversaw the accounts of several companies, contacted clients personally to gather research information on their satisfaction of services and offered additional assistance where requested.
Used Providing Outpatient Therapy telephonically Case management Clinical assessments Treatment planning and implementation.
Experience
10+ Years
Level
Senior
Education
Master Of Social Work
Jr. Clinical Care Manager Resume
Objective : Seeking a Clinical Care Manager position working with adults living with severe mental illness and/or substance abuse diagnoses in a residential, community or correctional treatment setting.
Skills : Social Work Case Manager, Mental Health Case Manager, Director Of Social Services, Mental Helath Program Supervisor, Clnical Social Worker, Hot Line Advocate, School Social Worker.
Description :
Managed the clinical referral line for over one million lives for members calling in for assistance with mental health and substance abuse treatment and referrals.
Handled complex medical cases and post-partum depression referrals.
Coordinated care with other departments including pre-certification for inpatient levels of care, utilization management appeals, and quality incentives.
Managed multiple applications simultaneously in Value Options member computerized database.
Handled crisis calls and provide counseling, intervention, and follow-up for urgent and emergent cases.
Attended multiple agency-wide trainings on cutting edge treatment strategies for substance abuse and mental health care.
Completed individual clinical assessments, treatment plans, and care management services for clients within behavioral health program.
Trained clinical care managers Reviewed and managed behavioral health disability claims.
Experience
2-5 Years
Level
Junior
Education
Masters
Clinical Care Manager III Resume
Summary : To find employment with an agency specializing and committed to empowering individuals facing difficult life experiences through continuity and quality therapeutic counseling, case management services, and education.
Skills : Care Assistant, Care Supervisor.
Description :
Reviewed request for new or behavioral rehabilitative services and managed a caseload of BHRS providers.
Chaired provider meetings to discuss provider specific concerns and facilitated case presentations.
Conducted initial and concurrent reviews for inpatient psychiatric care and substance abuse treatment.
Responsible for authorizing appropriate levels of care and developing treatment plans in accordance with medical necessity criteria.
Participated in interagency meetings to discuss treatment planning and service recommendations.
Provided direction and support to other Care Managers within the unit relating to clinical issues.
Coordinated with various departments within the Philadelphia Department of Behavioral Health to ensure authorized services are being provided.
Experience
7-10 Years
Level
Consultant
Education
Social Service
Clinical Care Manager II Resume
Summary : Flexible, creative professional employee with a variety of skills and strong management background is seeking a position that is fun, growth oriented, and involves purposeful work.
Skills : Clinical Manager, Clinical Assistant.
Description :
Categories of clients included pregnant or parenting women, medically compromised clients, MR clients, forensic clients, and clients with neurological difficulties.
Coordinated behavioral treatment plans for a designated caseload of clients.
Reviewed and authorized hospital and outpatient stay based on medical necessity.
Assisted hospitals with discharge planning efforts and ensuring continuity of care and support across all levels of behavioral care.
Maintained organization of patient database, which includes history of members' hospitalizations, medication regimen, diagnoses and treatment plans.
Consulted with physician regarding the best possible treatment plan and medication regimen.
Handled obstacles such as when clients refuse to comply with treatment planning designed for them.
Experience
10+ Years
Level
Senior
Education
Clinical Psychology
Clinical Care Manager I Resume
Summary : Experienced in recovery-focused, longitudinal and complex care management Diverse clinical experience in a variety of settings Highly motivated and able to work independently.
Skills : Clinical Specialist, Clinical Tech.
Description :
Coordinated and managed all components of federally funded HIV outreach treatment program.
Guided all chronically ill and high-risk patients through the health care system ensuring continuity of care.
Assessment and triage of acutely ill patients and recommendation of appropriate care and treatment.
Developed initiatives to improve patient treatment adherence, appointment attendance, and provider-patient communication.
Assessed HIV patient treatment outcomes by maintaining and mining a national database.
Reported patient outcome data and initiative effectiveness to health care and lay-community stakeholders.
Acted as lead clinical nurse educator and provided patient education and counseling regarding prevention, management, and treatment of acute and chronic illnesses.
Experience
10+ Years
Level
Senior
Education
BS In Nursing
Clinical Care Manager/Specialist Resume
Summary : To utilize knowledge gained from working in different roles from the front lines of behavioral health up through Senior Leadership to improve the delivery and quality of behavioral health services to the community.
Skills : Marketing Communications, Business Development, Senior Leadership, Behavioral Health Clinical Experience.
Description :
Responsible for initial clinical triage and referral activities, pre-authorization and concurrent review of all levels-of-care.
Ensured appropriate application of level-of-care criteria and that reviews are completed in a timely and efficient manner.
Triaged all calls for emergency, urgent and routine status.
Reviewed facility admissions for medical necessity and appropriateness in accordance with LOC criteria and policies.
Monitored treatment status for need for appropriate LOC.
Coordinated discharge planning for all hospitalized members by facilitating hospital discharge plans.
Served as a resource person for, and liaison between, physicians, hospital and other facility.
Prepared denial letters per URAC and company standards for physician signature.
Experience
7-10 Years
Level
Management
Education
Masters Of Community
Asst. Clinical Care Manager Resume
Summary : Clinical Care Manager has been expertise for many years. Have performed direct patient care, an effective manager for a health insurance company, and case management for another Senior HMO plan.
Skills : Medical Tech, Medical Supervisor.
Description :
Worked within the Medical Services department as Care Manager providing complex case management for approximately 3,000 members.
Responsible for management of all IPA's inpatient and skilled nursing admissions including assistance with discharge planning.
Responsible for UM, QM issues for IPA's assigned.
Paid all claims associated with members assigned and advised Medical Director if down coding was required.
Saved the company hundreds of thousands of dollar by extensive claims review.
Gave seminars on Medicare 101 for seniors turning 65 years of age.
Provided educational information for both DM and CHF as well as telephonic case management for SNP members.
Experience
7-10 Years
Level
Management
Education
M.A
Associate Clinical Care Manager Resume
Summary : Care manager for providing case management services to Medicaid members that have multiple health issues and high numbers of ER visits and inpatient hospital stays. As case manager, I assist members with medication management, disease management and treatment plan coordination. Perform in home visits to assess healthcare needs using a comprehensive health assessment.
Skills : Microsoft Office, Care Assistant.
Description :
Conducted field and telephonic case management for up to 150 members, performing a wide range of assessments.
Presented cases in weekly team meetings and conference calls.
Networked for patient support services, planned discharges, and performed concurrent reviews as well as ICD9 medical coding.
Provided ongoing patient education, disease management and medication management to increase compliance.
Met and maintained compliance with all regulations.
Noted for exceeding targets including quality of interaction and client satisfaction.
Recommended for a promotion to management prior to the economic downturn and consequent disbandment of the team.
Experience
7-10 Years
Level
Consultant
Education
Bachelor Of Science
Clinical Care Manager Resume
Summary : Over 10 years' experience in hospice and palliative care including work as a case manager, clinical care manager, director of nursing, director of quality improvement, public relations, community education and now as a regional director of operations.
Skills : Clinical Manager, Clinical Tech.
Description :
Responsible for hiring, staffing, determining workloads and duties of staff and initiating disciplinary actions or educational counseling.
Coordinated student preceptorship with local college.
Quality assurance and process improvement.
Developed RN mentor checklist for new nursing staff.
Maintained public relationships and customer retention and participated in new growth marketing events.
Compliance with the Hospice Medicare and DHEC regulations, State licensure regulations, and organizational policies and procedures.
Oversight of daily operations of Nursing, Spiritual Care Counselors, and Social Department.
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