Referral & Outreach Specialist - Jackson, MS
Referral & Outreach Specialist - Jackson, MS
L4
Occupations
Community and Social Service Specialists, All OtherChild, Family, and School Social WorkersSocial and Human Service AssistantsIndustries
Other Individual and Family ServicesAll Other Outpatient Care CentersOutpatient Mental Health and Substance Abuse Centers- 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 compliance
- Meets 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.
Level
MidL4
Location
Pascagoula, MS
Occupation
Community and Social Service Specialists, All Other
Industry
Other Individual and Family Services
Posted
5 days ago
To get sharper similar jobs, create your profile using the link below.