Clinician, Central Access Team Position Available In Kennebec, Maine

Job Description:

POSITION SUMMARY

This position is responsible for maximizingaccess to inpatient behavioral health care and patient movement forthe Department of Behavioral Health. Admissions for our InpatientBehavioral Health beds require the ability to form relationshipswith area hospitals, emergency rooms, nursing homes and providers,timely and efficient responses to requests for beds, coordinationwith medical staff, and the ability to present cases conciselywhile covering important clinical detail. This position works incollaboration with Director of CAT, Nurse Managers, CrisisServices, and Utilization Review. Responsible for patient movementacross the system. Assists with verification of benefits, and priorauthorization for services to ensure payment with perspectiveinsurance companies. Develops a working knowledge of the variouspayers admission criteria to ensure that the requirements forpre-certification are met. Works with prospective patients,families, and referring professionals. Works to maximize access toservices across the inpatient BH service line. Providesextraordinary customer experience, understands needs of callers andbreadth of service in our system of care. Has a high level ofunderstanding of available resources within the Behavioral Healthcontinuum of care locally, regionally, and statewide.

EDUCATION/CERTIFICATION

Masters Degree and licensed/certified in aBehavioral Health field is required.

EXPERIENCE

Minimum of ten(10) years of experience in the Behavioral Health field withUtilization Review required. Must have experience in caring forthose with mental health, substance use, and co-occurringdisorders. Requires experience with benefit verification,eligibility, pre-authorizations, and admission criteria.

COMPETENCIES

Must have excellent verbal and written communicationskills to effectively communicate with and be responsive to medicalstaff, referral sources, patients, family, and a multitude of othercustomers who interface with areas of responsibility. Requiresexperience working with and understanding hospital-based inpatientbehavioral health care. Must have experience working with managedcare and understanding of prior authorizations and utilizationreview. Must be familiar with requirements to meet hospital levelof care, including basic symptomology, required labs, importance ofobtaining medication reconciliations, and accepting appropriateinsurance plans.

ESSENTIAL

DUTIES and

RESPONSIBILITIES

Disclaimer:

Job descriptions are not intended, nor should they be construed tobe, exhaustive lists of all responsibilities, skills, efforts orworking conditions associated with the job. They are intended to beaccurate reflections of the principal duties and responsibilitiesof this position. These responsibilities and competencies listedbelow may change from time to time. Coordinate admission andtransfer between levels of care within the facility. Communicateprojected admissions to designated internal representatives in atimely manner. Maintains optimal census across all units.

Establishes positive working relationships with community referralresources to increase admissions to behavioral health fromsurrounding hospitals. Perform insurance benefit verifications andprior authorization for admission. Ensure all medical admissiondocumentation is gathered from external sources prior to patientadmission. Assist crisis services with prior authorization whentime allows to facilitate timely patient throughput. Reviewclinical data and determine appropriate level of care for patientafter consulting with the attending physician. Completes an intakeform, documenting patients clinical information and disseminates tothe interdisciplinary treatment team. Contacts Utilization Reviewclinician with authorization and follow up reviews. Assists crisisservices with referring outside of system to find appropriate bedswhen time allows. Understands the balance between service areaadmissions and outside admissions in order to maximize provision ofcare for behavioral health patients.