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Referral & Outreach Specialist - Hattiesburg, MS
4 months ago
Founded in 1912 as an adoption agency, Canopy Children's Solutions is Mississippi's most comprehensive nonprofit provider of children's behavioral health, educational, and social service solutions. Canopy employs a diverse group of mission-driven individuals committed to honoring the voice of Mississippi children and families. Being an integral part of the Canopy team involves committing to the Core Values that drive our organization forward:The voice of our children and families always comes firstRelationships matter and our differences make us strongerWe take great joy in service to othersOur families and our communities deserve our very bestCanopy has been designated a Great Place to Work® for the fourth consecutive year, and is one of only eight companies in Mississippi to qualify for this certification in 2023-2024. Canopy's employees are charged with building a healthy work culture within their teams, that focus on trust, and the collective goal of helping kids thrive and families to overcome extraordinary challenges.Position OverviewThe Referral and Outreach Specialist serves as Canopy Children's Solutions liaison to families, community partners, and referral sources.The Referral and Outreach Specialist provides administrative, clerical, and clinical support to the Intensive In-Home Solutions clinical and wrap around teams while helping families navigate and obtain needed solutions to thrive.The Referral and Outreach Specialist coordinates intakes, referrals, initial screening and assessments, prior authorizations, and admissions with the regional teams and the admissions department.Additional job functions include monitoring and supporting regional census goals through triaging and outreaching to increase referrals, increase awareness of the Organization through marketing and outreach, conduct internal audits and manage timeframes for quality and assurance compliance.Travel is required within the assigned region.Job Responsibilities:Outreach functions: Provides initial screening to callers to determine if needs are appropriate for requests for treatment and level of care.Provides referral services through linkage and outreach when solutions criteria are not met that's being requested.Provides guidance to referral sources, parents and community partners on the organization's referral and intake process according to medical necessity criteria.Manages incoming calls and process calls related to treatment/care request.Administrative functions: Assists families with intakes by gathering and preparing the required preadmission clinical documents.Collects, compiles, and prepares clinical documentation and treatment history required for determining clinical eligibility and submission to request treatment authorization for admission.Communicates with the referral sources and families throughout the pre-admission process referral status updates according to program timeframes.Schedules and conducts staffing of referrals for admission and facilitate discussions regarding the need for care/treatment and current status.Submits the completed pre-admission prior authorization packet to the Admissions Coordinator for processing with the designated payer.Coordinates and schedules admissions.Coordinates and schedules the initial psychiatric evaluation for the new admit.Monitors the Medicaid eligibility status of active referrals and triage accordingly based on discoveries made during eligibility verifications.In conjunction with the Utilization Management Staff monitors and coordinates Medicaid eligibility status of active cases and coordinate with the utilization review coordinator and the team any action required by the family to maintain Medicaid coverage.Assists as designated and assigned with quality assurance activities.Prepares for any on-site compliance reviews with Division of Medicaid, Managed Care Organizations, and Department of Mental Health for the Region as applicable.Attends/facilitates as required and requested weekly staff meetings.Demonstrates familiarity with all emergency procedures and satisfactorily implements procedures as applicable.Demonstrates sensitivity and responsiveness to cultural differences in the organization/program service population.Provides coverage to admissions staff duties as assigned and requested to ensure overall work goals are accomplished.Adheres to identified work schedule set by the Director of Admissions and/or Leadership.Promotes Canopy Children's Solutions to the public.Promotes the organization's Mission and Values.Appropriately utilize and accept supervision.Provides transportation when necessary.Complies with scheduled Organization training and in-services for complianceMeets all key performance indicators (KPI).Travel as required and necessary to fulfill job related duties.Other related duties as assigned.Reporting functions:Prepare and complete program reports as assigned and requested.Monitor and track authorization of services through service reports to coordinate with the utilization management staff prior authorization requests for continued stays or concurrent reviews.Use service reports to monitor documentation and ensure requirements are met.Use established reports to monitor compliance with referral to admission standards.Required Qualifications:Must have a minimum of a Bachelor's Degree in a behavioral health field, and prefer two years of experience working with emotionally and/or behaviorally disturbed youth.Prefer one year of experience working in a behavioral health care setting.Must be able to communicate in a therapeutic and professional manner.Computer skills required.Must be at least 21 years of age, have a valid Mississippi driver's license, a good driving record, proof of legally appropriate auto liability insurance, and must be willing to use personal vehicle for organization business.Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
