PartnersACCESS Specialist (QP)-Remote-NC (PRN)

🌍 Remote, USA πŸ’Ή Full-time πŸ• Posted Recently

Job Description

About the position Responsibilities β€’ Initial screening of Health/Mental Health (MH)/Substance Use (SU)/Traumatic Brain Injury (TBI)/Intellectual/Developmental Disability (I/DD) treatment needs, benefit information and referral of members calling to determine if they may potentially qualify for services β€’ Collect and enter demographic data into the electronic record, completion of appropriate forms, explanation of services, benefits and resources, verifies Medicaid and dispatch β€’ Provide follow up calls to referral sources and members to ensure that members have been successfully engaged in services β€’ Make referrals to clinical homes and crisis providers that meet the timeliness standards as defined by NC Medicaid β€’ Provide information about local community resources, independent practitioners, and related providers for referrals for basic benefit services β€’ Assist with authorizations/admissions to state hospitals, ADATC, Three Way Hospitals, Level III Detox, Facility Based Crisis and all referrals to crisis services β€’ Process other acute care authorizations as requested by supervisor or other Access to Care Licensed Clinician β€’ Screenings are completed using standard and specialized computer programs β€’ Input accurate information into the system and unlock electronic service records with appropriate consents, enters all necessary data elements into data systems β€’ Provide technical assistance to First Responders, clinical home providers, and Mobile Crisis Management β€’ Establish and maintain effective working relationships within the unit, agency, and service system β€’ Demonstrate professionalism, tact and diplomacy in handling irate callers and/or working with contract providers and other external parties β€’ Participate in Unit Staff meeting, Agency Staff meetings, (All staff meetings) and assigned committees Requirements β€’ Bachelor's Degree in related field or Licensed Practical Nurse (LPN) and at least two (2) years of healthcare or MH/SU/IDD experience β€’ Sound knowledge of health/MH/SU/TBI/I/DD for the appropriate determination of eligibility for Medicaid and State supported services β€’ Knowledge of the laws governing the treatment of health, mental illness, substance abuse and intellectual/developmental disabilities β€’ Knowledge of call center functions, member population, potential for crisis issues, confidentiality laws and program protocols/policies β€’ Excellent computer skills β€’ Ability to complete tasks independently, define problems, apply laws, policies and procedures to agency activities β€’ Ability to communicate effectively orally and in writing, have good keyboarding skills and be able to multi-task β€’ Ability to take highly complicated criteria and apply it to cases in determining eligibility for services and appropriate scheduling referrals β€’ Ability to assist members in highly stressful situations which may be life threatening to the member or public Nice-to-haves β€’ Licensed practical nurses (LPNs) and at least four (4) years of healthcare and/or MH/SU/IDD experience Benefits β€’ Not eligible for benefits Apply tot his job

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