Job Details
Qualifications
- Bachelor's degree
- Behavioral health
- Care plans
- Computer skills
- Driver's License
- Master's degree
- Medical records
Job Description
Overview
SummitStone Health Partners has an exciting opportunity for a Utilization Clinician to join us and experience a level of caring and a spirit of teamwork that is uncommon in behavioral health today. We provide much-needed services for people at their most vulnerable times, often overlooked and under-served. We know we must support our teams passionately and with dignity to succeed in our purpose.
We Embrace Diversity
We welcome and actively seek applicants (people) of different backgrounds, identities and experiences. SummitStone is committed to fostering a diverse and inclusive environment, honoring each individual's whole-self by embracing differences in race, ethnicity, ability, age, gender, sexual orientation, spiritual beliefs, socioeconomic status, language and the inherent intersections of many different identities. We invite everyone to share our journey and are proudly an equal opportunity employer.
Location: Garcia - Fort Collins, Colorado
Status: Full-time, 40 hrs./week
Participate as a member of the treatment team to lead the utilization review, authorizations and transitional case management for all clients accepted to Garcia House. Additionally, the position will assist with the individual care plans for program clients in accordance with policies, rules, regulations and directives that apply. Coordinates with internal as well as external supportive resources to deliver needed services to client/consumer. Provide supportive services related to milieu management and client care within a 24 hour residential program.
Essential Duties:
Manage all utilization records and processes, including pre-authorization forms, continued authorization forms and review of clinical information for medical necessity.
Understanding of the ASAM assessment and ability to complete the assessment for clients.
Conduct concurrent reviews, extensions of care, discharge planning and retrospective reviews.
Coordinate authorization calls between payers and treatment team.
Interacts regularly with federal, state and local entities to create opportunities to deliver services to client/consumer. Represents clients/consumers with these entities to get services, amend services, or re-instate services.
Perform clinical care including assessments, diagnoses, groups etc as needed to support the program.
Assists with monitoring clients in milieu and providing services that aid in client treatment plan goals
Advocate for consumers in many different forums including at the federal, state and local court systems, with family, school system etc.
Maintain accurate record-keeping, and prompt communication with all individuals involved with the approval of service and payment, including the treatment team and revenue cycle department.
Establish effective rapport with other employees, professional support staff, clients and families, and others involved in providing coordinated care for clients. This includes managing relationship with other public agencies and supportive services.
Collaborate as a member of an interdisciplinary team. Contribute actively and effectively with the medical provider, clinical staff, and other members of the healthcare team to ensure appropriate plans of care, along with appropriateness of services being rendered. As well as collaborate with the Revenue Cycle department to understand billing and coding practices and processes for reimbursement and payment of services rendered.
Relay information to the multidisciplinary treatment team regarding authorization review results and assist with coordination of care as required.
Assist with facilitation of discharge planning process
Willingness to administer CPR/First Aid as needed
Perform other duties as assigned
May participate on committees (both internal and external), in meetings, and works on projects.
Superior computer skills including learning new monitoring programs and/or electronic medical record.
Experiences and Background We Look For
Job Requirements:
Strong organization skills, efficient time management and ability to manage and prioritize multiple tasks
Knowledge of complex medical and behavioral health conditions and national standards of care
Knowledge and understanding of medical records, health insurance and billing criteria preferred
Demonstrated ability to problem-solve complex, multifaceted situations with a client advocacy focus
Excellent interpersonal skills
Computer literacy on Microsoft Office products, spreadsheets, electronic health record systems and database programs
Effective verbal and written communications skills. Coordinates with internal as well as external supportive services to deliver needed services to client/consumer. Collaborates with peers and psychiatrist regarding treatment.
Knowledge of federal, state and local regulations regarding delivery and documentation of behavioral health services
Minimum qualifications:
1 - 3 years minimum of directly relevant experience in behavioral health client care and/or inpatient utilization management in behavioral health, care coordination and/or case management for high-risk populations.
Must have valid driver’s license and ability to be commercially insured.
Ability to produce written documentation of work in a manner readily understood by other service providers.
Ability to be flexible in carrying out diverse job duties.
Ability to provide an appropriate and responsible role model through actions and appearance.
Ability to deliver services based upon the client’s needs.
Experience in coordinating mental health intervention plans and services with other agencies.
Bilingual in Spanish and English preferred.
Education & Licensure
Master’s Degree in Human Services field from accredited College or University or equivalent experience.
LAC required
Physical Demands:
Occasionally lift and/or move up to 25lbs.
Frequently required to walk, sit, stand or kneel and occasionally required to climb or balance and stoop.
Must have ability to sit for longer periods of time at a computer.
Must be able to travel between agency and partner organization locations.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Working Conditions:
This position is non-exempt (Eligible for overtime).
This positions workload is based on number of hours worked per week.
This position may include additional hours beyond 40 hours per week upon supervisor approval
Wage Ranges
Based on a 40-hr. work week.
Wage range $52,958.50 - $66,198.12.
Bachelor Degree - $17.06/HR to $23.89/HRut SummitStone health, or to apply on our site, visit us at www.summitstonehealth.org/careers/