|Title:||Patient Care Coordinator; Full Time|
|Location:||1220 Willis Avenue, Daytona Beach, FL 32114|
$12.13/hr - $14.78/hr BA Degree DOE/Certification
$14.42/hr - $17.14/hr MA Degree DOE/Certification
Working Hours: 40 hrs week; Mon-Fri; 10a-7pm; Monday - Friday
***This is a temporary position***
At Minimum a High school Diploma and 6 years of direct care experience working in the Human services or related field. Graduation from an accredited school with a Bachelor degree in Human Services or a related field or a Master’s Degree or Certified Addictions Professional (CAP) preferred. Within the last five years must have had two years of experience in behavioral health treatment services. One year of experience in a setting where it was necessary to communicate orally and in writing to inform, advise, or train others about client issues, treatment service delivery, documentation in client records or UM principles. Experience with American Society of Addictions Medicine Patient Placement Criteria is preferred. Experience with CARF, Medicaid, and Managed Care requirements is preferred.
- Must be knowledgeable and demonstrate competency in current best practices of behavioral health treatment and related services, especially as it relates to documenting the course of treatment and patient placement criteria in the client record.
- Depending on assignment must have knowledge of typical diagnoses, treatment services, and developmental issues for adolescents in general, delinquent adolescents, adults and pregnant/post partum women who are admitted to a mental health and/or substance abuse treatment setting.
- Demonstrates proficiency with assigned client populations in performing utilization reviews in records of clients with specific problems and needs.
- Knowledge of growth and development.
- Ability to assess age specific data.
- Ability to interpret age specific response to treatment.
- Knowledge of the treatment needs of adolescent mental health, substance abuse, co-occurring, ADD, ADHD, conduct, and oppositional defiant disorders.
- Knowledge of the treatment needs of adult mental health, substance abuse, and co-occurring diagnoses of affective disorders, anxiety disorders, PTSD, and antisocial personality disorder.
- Knowledge of the treatment needs of adult pregnant/post -partum women with mental health, substance abuse, and co-occurring diagnoses of affective disorders, anxiety disorders, PTSD, and antisocial personality disorder.
- Proficiency in working with telephone system and telephone etiquette.
- Proficiency in working with computer hardware and software, when assigned.
- Completes calls from individuals inquiring about services, who are in need of immediate assistance, admitting to services, need information regarding services and community resources and linkage to SMA behavioral services.
- Provides information on Baker Act and Marchman Act.
- Provides solution focused supportive counseling and linkage to individuals that need immediate services
- Collect demographic and insurance data, register new clients for services, verify insurance
- Eligibility and benefits and enter financial eligibility and authorization data in our Avatar EMR system.
- Conduct authorization reviews with insurance companies for clients admitted to services.
- Notify staff of insurance authorizations through email and/or phone calls notifying them of authorization and insurance company expectations for the next review.
- Acts as an advisor to the program staff and supervisors through in-service trainings, individual meetings and written communications on all issues pertaining to the documentation expectations of insurance companies and other third party payers.
- Performs concurrent reviews as assigned by Clinical Compliance Director of client records in accordance with operating procedures of SMA UM Plan to certify appropriateness of admission and continued stay and discharge planning based on the criteria of the UM Plan.
- Performs retrospective reviews as assigned by Clinical Compliance Director of client records according to the operating procedures of the UM Plan to certify discharge appropriateness of discharge/referrals based on the criteria of the UM Plan.
- Writes and distributes to staff legible, informative, and understandable notices of non-compliance issues identified through reviews of client records with copies to their supervisors.
- As assigned, assists in the development of operating procedures and admission, continued stay, and discharge criteria for SMA's UM Plan with members of the PIC and/or the Clinical Compliance Director.
- Improves professional knowledge and skill base relevant to utilization management by attending seminars, trainings, and conferences and by reading current literature.
- Participates in required SMA in-service trainings to maintain employment.
- As assigned, assists in the maintenance of SMA's compliance with treatment and documentation requirements of funding sources, performance improvement, and accreditation activities.
- Acts as liaison between SMA staff and insurance companies, funding sources, or their managed care organizations when client’s health care is being managed under a managed care plan.
- When assigned or review requires it, coordinator is knowledgeable of up to date standards/criteria of ASAM PPC, Medicaid, a particular MCO, DCF, and CARF.
- Makes commitment to SMA’s mission and core values the SMA Way
- Abides by principles of EEO compliance and a workplace of dignity and respect.
- Works cooperatively in a group/team setting.
- Shows respect to others.
- Takes guidance and direction from supervisors.
- Arrives/Reports to work on time and ready to work.
EEO Employer W / M / Vet / Disabled