Behavioral Health Care Specialist

2 weeks ago

Manchester, Connecticut, United States ECHN Full time

POSITION SUMMARY: As a Behavioral Health Clinician at ECHN, you will play a critical role in maximizing access to inpatient behavioral health care and patient movement. This involves forming relationships with area hospitals, emergency rooms, nursing homes, and providers to facilitate timely and efficient responses to requests for beds. You will also coordinate with medical staff, assist with verification of benefits and prior authorization for services, and work to maximize access to services across the inpatient BH service line.

KEY RESPONSIBILITIES:

  • Coordinate admission and transfer between levels of care within the facility.
  • Communicate projected admissions to designated internal representatives in a timely manner.
  • Maintain optimal census across all units.
  • Establish positive working relationships with community referral resources to increase admissions to behavioral health from surrounding hospitals.
  • Perform insurance benefit verifications and prior authorization for admission.
  • Review clinical data and determine appropriate level of care for patient after consulting with the attending physician.
  • Complete intake forms and document patient's clinical information.
  • Contact Utilization Review clinician with authorization and follow-up reviews.
  • Assist crisis services with referring outside of system to find appropriate beds when time allows.

REQUIRED QUALIFICATIONS: A Master's Degree and licensed/certified in a Behavioral Health field is required. Minimum of ten (10) years of experience in the Behavioral Health field with Utilization Review required. Must have experience in caring for those with mental health, substance use, and co-occurring disorders. Requires experience with benefit verification, eligibility, pre-authorizations, and admission criteria.

DESIRED QUALIFICATIONS: Excellent verbal and written communication skills, experience working with managed care and understanding of prior authorizations and utilization review, and familiarity with requirements to meet hospital level of care.

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