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Residential Treatment Coordinator
2 months ago
Jefferson Center is seeking a highly skilled Utilization Management Coordinator to join our team. As a key member of our clinical operations team, you will be responsible for ensuring the efficient and effective management of our residential treatment program.
Key Responsibilities- Manage medical necessity evaluations to determine the appropriateness of level of care for clients.
- Serve as a liaison between clients, referral sources, stakeholders, and insurance companies to negotiate and advocate for client length of stay and level of care.
- Oversee utilization review activities to ensure reimbursement for services.
- Lead daily treatment team meetings and manage authorizations/reauthorizations and reviews.
- Work with the business office and admissions departments to complete preliminary verification of benefits.
- Manage RAE/insurance/contracts for admissions in cooperation with external stakeholders to ensure all information and processes are completed to support billing.
- Provide accurate and detailed billing information in electronic medical record systems.
- Ensure compliance with policies, procedures & regulations; maintain quality of records.
- Accurately enter incoming client information into electronic medical record systems.
- Distribute intake information to key individuals.
- Assist in the coordination of Involuntary Commitments and approvals for extended stays, if appropriate.
- Ensure consumers referred to Residential/Inpatient program meet the identified ASAM level of care and that pre-authorizations are approved prior to admission or prior to transfer/discharge to other levels of care.
- Accurately and concisely complete the Census Report for the end of each shift.
- Provide ongoing feedback and information on the status of admissions to clinical team members to coordinate intake and admission efforts.
- Maintain strong customer service including supporting youths and parents who may be in crisis with assistance from other JCMH staff members.
- Be an active team member including assisting in training new staff, advocating for the needs of the team with regard to best serving the clients, and identifying areas for improvement of the admission process.
- Effectively respond to the client/consumer needs and problems, initiate and maintain positive interactions with colleagues and community partners, and exhibit timely response to requests.
- Successfully complete all required training in a timely manner & attend key internal meetings as assigned.
- Follow and enforce all Jefferson Centers' Policies and Procedures, including but not limited to confidentiality, sexual harassment/harassment, dual relationships, physical and sexual abuse reporting, Corporate Compliance and Code of Ethics.
- Participate on various interagency committees as requested by Program Manager.
- Participate in supervision by coming prepared with an agenda. Reports high risk/problem cases using a problem-solving approach as well as feedback.
- Monitor, coach, and direct clinical team on implementing strategies to reach performance measurement benchmarks.
- Attend mandatory in-services, staff meetings, clinical supervision, and on-line training as required.
- Share knowledge of recovery-based, stages-of-change, motivational interviewing, cognitive-behavioral, solution-focused, trauma informed and culturally competent treatment. Ensure staff adhere to the EBP programing designed to successfully treat individuals with co-occurring disorders.
- Participate in staff development activities that enhance professional growth.
- Model a trauma-informed approach by having an understanding of how trauma impacts the lives of the people being served to best ensure that every interaction is consistent with the recovery process and reduces the possibility of retraumatization.
- Ensure that delivery practices are guided by the principles of trauma informed care and the principles of addiction treatment.
- Maintain effective interpersonal relations with consumers, peers, subordinates, upper management, visitors, and the general public. Uses language and behavior to promote dignity and respect.
- Corporate Compliance including documentation on practice in accordance with regulatory requirements and clinical guidelines.
- Exhibit enthusiasm, respect, adaptability, flexibility, and spirit of cooperation in the work environment.
- At least 21 years of age.
- Master's degree required. Master's degree in a related field (psychology, counseling, human services, social work, etc.) and LAC (able to be obtained within 6 months of hire) or CAS required.
- Supervisory experience preferred.
- Experience in substance use residential services as well as integrated behavioral health and/or community mental health setting preferred.
- Excellent communication skills both verbally and in writing, including computer skills. Multi-tasking abilities, adaptability to change, and demonstrated excellent customer service skills.
- Understanding of medical terminology, insurance verification, billing, inpatient medical/hospital setting preferred.
- Positive attitude, team player, and a desire to make a positive difference in the lives of adolescents and their families struggling with substance use disorders.
- Candidate must pass stringent background check including federal, state, Trails, CAPS, and Fingerprinting checks. Candidate must also pass 10 panel drug screening (including THC).
