Employee Assistance Program Nurse - Roseville, Minnesota - NurseRecruiter.com

Permanent Nursing Job in
Roseville , Minnesota, 55113

  • Employer: TEAM
  • Profession: Registered Nurse
  • Specialty: Case Manager / Utilization Review
  • Compensation: 62-67k

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TITLE: E.A.P. Nurse
Reports to: Executive Director of EAP

PRIMARY RESPONSIBILITIES:

 Act as the TEAM lead liaison with Medical Advocacy Program (MAP) on high-risk behavioral health cases.
 Interface with MAP on cases where the client has a co-morbid issue that is impacting their behavioral health condition.
 Participate in scheduled conference calls with MAP to staff cases that are being managed by both EAP and MAP.
 Attend monthly conference calls with stakeholders to discuss additional ways to work with MAP, designated fund, pharmacy benefit manager and health plan to meet needs of members.
 Maintain client records and notes of services provided.

 Assist in conducting medical necessity reviews in accordance with contracts. This will include reviewing case notes submitted by providers, evaluating treatment recommendations and following up on high risk cases.

 Assist in developing care guidelines for case reviews.
 Review claims to confirm the quality and necessity of services rendered.

 Develop a systematic approach to follow up calls with members primarily using the techniques of Motivational Interviewing (MI).

 Develop/implement model for frequency of calls.

 Demonstrate comfort in working with members that may have both MI/CD issues.

 Play an active role in a case management function related to high claims cases and complex cases with co-morbidity concerns.

 Collaborates with treatment providers on treatment plans

Data Collection Accuracy

 Maintain accurate case notes that reflect the correct dates and amount (times) of services and chart the data from the session, assessment and plan.
 Maintain accurate records of time spent in direct service to clients as well as peripheral services such checking collateral or researching appropriate referrals.
 Participate with internal data collection requests designed to promote analysis of company resources and needs.


Insurance/Benefit Administration/Facilitation

 Verify benefit information on HMO/PPO insured clients, as well as union self-insured clients, prior to referring them to an outside agency or provider for services.
 Assist clients in determine the highest level of care and reimbursement specific to the clients benefit plan and will help educate clients on their co-pays, deductibles, and in-network panel providers.

Ethics Adherence

 Must adhere to the ethical principles of EAPA as well as to their practice domain, such as: psychology, marital and family therapy, professional counselor, social work, alcohol and drug counselor, etc.
 Abide by codes of conduct specific to EAPA and their practice domain. Ex. Board of Psychology, Department of Health and Human Services, Marriage and Family Board, Nursing Board etc.
 Know and carry out all duties of mandated reporting for State and Federal Statutes.
 Work within their areas of competence, take steps to avoid impairment (or seek help if they become impaired), avoid dual relationships with clients, adhere to HIPAA regulations with regards to client records and confidentiality, and accurately represent their training, credentials, and competencies.
 Inform clients of their rights and limits of confidentiality.

ADDITIONAL RESPONSIBILITIES:

Benefit Case Management

 Handle calls from clients and providers and assist in benefits case management duties and roles.
 Provide consultation to managers, supervisors and Human Resource personnel of contracted accounts in dealing with problematic employees and facilitating formal referrals and follow through of recommendations.


Knowledge and Acquisition of Community Referral Sources

 Will have a responsibility to their clients to continue to compile and build a network of community resources and share this information with colleagues.
 Will provide updated referral and resource information changes to office staff or input information into EAP software on their own.
 Will solicit new providers and subcontracts for certain geographic locations and specialty services as needed.


Personal and Organization Development

 TEAM encourages counselors to participate in continuing education.
 Nurse will maintain professional degrees and credentials.
 TEAM encourages counselors to continue personal and professional growth through professional organizations.
 Nurse will maintain personal and professional balance (as determined by the counselor) by engaging in outside events such as: social activities, relational activities, therapeutic services, spiritual or any other venue to promote “self-care.”
 Will consult with peers on cases and provide consultation to those seeking it.
 Will carry out special assignments for the organization as needed.
 Will assist in the development of internal and external programs as needed.
 Assist in administrative and office duties (answering phones, scheduling appointments, etc.) as needed.


SKILLS NEEDED:

 Ability to handle a varied and complex caseload.
 Innovative thinking related to delivery of care for members with complex medical and behavioral health issues
 Able to take initiative to in finding right level of care for members
 A team player that demonstrates a comfort level in interacting with a variety of stakeholders from multiple disciplines
 Ability to multi-task daily
 Strategic thinker in being able to develop cutting-edge models for delivery of health care via the EAP platform.
 Responsiveness to requests by funds to blend EAP with fund initiatives around delivery and cost of health care
 Ability to develop/build relationships with network of treatment providers
 Proficiency with Microsoft office suite, Excel, and Power Point applications
 Experience with case management function and responsibilities.
 A minimum of three years’ experience working with behavioral health (psychiatric and chemical dependency) clients.

Educational/Experience Requirements:
 Bachelor’s degree in Nursing from an accredited nursing program.
 At least 3 years Mental health/Chemical Dependency experience


Work Hours:
 Will work primarily day shift (8-4:30pm) but may be required to work other times based on needs of our members.

Job Requirements

Bachelor’s degree in Nursing from an accredited nursing program.
At least 3 years Mental health/Chemical Dependency experience

Location

Roseville, Minnesota , 55113

Employment Type

Permanent

Compensation

62-67k

Employer

TEAM

Date Posted

Oct 3rd, 2017

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