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Inpatient Behavioral Health Care Navigator
2 months ago
This position is responsible for maximizing access to inpatient behavioral health care and patient movement for the Department of Behavioral Health at ECHN.
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.
- Ensure all medical admission documentation is gathered from external sources prior to patient admission.
- Assist crisis services with prior authorization when time allows to facilitate timely patient throughput.
- Review clinical data and determine appropriate level of care for patient after consulting with the attending physician.
- Complete an intake form, documenting patient's clinical information and disseminate to the interdisciplinary treatment team.
- 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.
- 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.
- Must have excellent verbal and written communication skills to effectively communicate with and be responsive to medical staff, referral sources, patients, family, and a multitude of other customers who interface with areas of responsibility.
- Requires experience working with and understanding hospital-based inpatient behavioral health care.
- Must have experience working with managed care and understanding of prior authorizations and utilization review.
- Must be familiar with requirements to meet hospital level of care, including basic symptomology, required labs, importance of obtaining medication reconciliations, and accepting appropriate insurance plans.
