- 1. Admission Function:
- 1.1 Conducts clinical intake evaluations with referral sources payers, patients, and families to determine medical necessity for admission and the appropriate service and level of care.
- 2. Utilization Management Function:
- 2.1 Conducts utilization management activities to secure admissions certification, concurrent reviews, re-certification, discharge reviews with insurance carriers for both inpatient and outpatient services.
- 3. Additional Duties:
- 3.1 Assumes rotating call admissions coverage evenings and nights, Monday through Friday, as well as 24-hour weekend coverage, as needed. Required to be accessible by pager at all times during assigned on-call shifts to screen and process emergency inpatient admissions. In collaboration with PFAS, staff to make best efforts for securing financial eligibility of patients.
Coord Psych Admissions - New Haven, United States - Yale New Haven Health
Description
Overview:
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Provides admission and utilization management services for all ambulatory and inpatient delivery networks for Yale-New Haven Psychiatric Hospital (YNHPH).
EEO/AA/Disability/Veteran
EDUCATION
Masters Degree in Social Work, Counseling, Substance Abuse, Marriage and Family therapy, or Graduate Baccalaureate degree in Nursing are strongly preferred. Candidates with a Masters Level degree that does not lead to a clinical licensure will also be considered, but only when the candidate's Masters Degree includes at least one year's educational focus on general psychology/organizational psychology/applied psychology AND the candidate also has a well rounded understanding of patient diagnostics with a firm understanding of hospital based psychiatric systems.
EXPERIENCE
Three (3) years experience in a behavioral healthcare/Substance Abuse Treatment setting or relevant work experience.
LICENSURE
Current licensure in the State of Connecticut of LADC, MSW, RN, LCSW, LPC, LMFT, or equivalent education and professional experience is strongly preferred. Unlicensed candidates will also be considered in limited exclusive circumstances (see Education section for these details).
SPECIAL SKILLS
Knowledge of acute psychiatric treatment, treatment settings/clinical level of care guidelines, psychiatric diagnoses, behavioral health utilization review and appeals procedures. Excellent interpersonal communication skills are a must, as are independent analytical problem-solving skills, leadership ability, casework skills and computer skills (including word processing, data entry, and data analysis). Must be able to diplomatically establish clinical credibility with clinical treatment and administrative teams. Interpersonal skills must be very sharp in order to most successfully facilitate negotiations for scarce psychiatric resources, and to facilitate changes in systems and/or practices. Excellent communication skills with the ability to work effectively with multiple disciplines and skill levels. Ability to quickly process complex problems, identify key components, and develop plans for resolution. Effective interactions with all clinical team and administrative members and the ability to elicit their cooperation. Demonstrated skills in clinical management of specific patient populations. Ability to provide clinical/financial education to colleagues, patients and families.