- Work collaboratively with clinicians in the Acute Psychiatry Service and Consult Liaison services to assist with patients' discharge from the emergency or hospital setting to other psychiatric or medical settings.
- Receive prior authorizations from payors to assure a seamless and timely transition of these patients out of the hospital and into an appropriate next level of care
- Collaborate and consult with patients, families, professionals, and providers inside and outside the hospital to develop and implement pre-admission, inpatient, post hospital, and outpatient care.
- Check in with patients and families during their ED or hospital stay to provide updates on treatment plan, status, and answer questions.
- Arrange outpatient follow-up appointments for patients being discharged, which may include obtaining new psychiatry and therapy appointments, obtaining new PCP or medical/surgical appointments and documenting appointments the electronic health record.
- Make referrals to partial hospital programs or other alternate levels of care by providing documentation to support patients' transfer to other facilities.
- Phone/fax contact with other mental health facilities, preparing information to fax, copying portions of the medical record, scheduling intake appointments for patients.
- Refer to and collaborate with interdepartmental specialists and programs, outside agencies, facilities, payors, and other relevant community resources.
- Maintain an understanding of the requirements and restrictions of specific patient insurances and what resources the patient may be eligible for.
- Research and secure resources utilizing the central resource database and maintain a current list of active resources.
- Map insurance and geography to identify appropriate resources; assess insurance benefits and coordinate the necessary paperwork with the external facilities and medical team such as letters of medical necessity.
- Attend and participate in interdisciplinary meetings and staff meetings as needed.
- Serve as the primary liaison between the MGH medical floors and the system behavioral and mental health access team when working on the Consult services.
- Develop the expertise to understand and articulate patients' unique care needs and any barriers to potential placement with the next level of care.
- Collaborate closely with the system behavioral and mental health access center team, following predetermined workflows to ensure synergy and efficiency.
- Arrange for and tracks delivery of paperwork prior to discharge or transfer.
- Works collaboratively with the floor Case Manager and Ambulance Services Transportation Liaison for the hospital to coordinate the various modes of discharge transportation.
- Access and navigate the electronic health record to obtain essential information and document progress per department standards.
- Provide coverage for the APS clinical social worker and other psychiatry staff other as appropriate.
- Perform other duties to support clinical care of patients as needed
- Comfort with learning new technology and learning digital tools
- Excellent computer skills
- Interest in process improvement and evolving needs of the position
- Excellent interpersonal, collaborative, customer service and advocacy skills
- Excellent written and verbal communication skills
- Excellent organizational and time management skills; ability to multitask in a fast-paced environment
- Excellent judgment and ability to work independently in a unique position
- Ability to be flexible and resourceful
- Assessment and problem-solving skills
- Familiarity with mental health treatments, systems of care, and community resources
- Experience working with insurance networks desirable
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Resource Specialist - Boston, United States - Partners Healthcare System
Description
GENERAL SUMMARY/ OVERVIEW STATEMENT:
Working as part of a collaborative care team with the residents, attending psychiatrists, nurse practitioners, social workers, and nurses the Resource Specialist will facilitate placement for psychiatric patients on the Acute Psychiatry Service (Emergency Department) and Pediatric & Adult Inpatient Consult services.
Under the supervision of the APS Social Work Lead, the Resource Specialist works collaboratively with the medical, psychiatry, and system behavioral health teams, to provide direct administrative support to the discharge planning processes.
The person in this position will spend time in the Emergency Department and on the clinical units and have direct interaction with patients and their families, clinical and ancillary hospital staff, and other internal and external customers.
The position requires a high degree of flexibility, independence, and willingness to participate in multiple activities in providing support clinical teams, patients, and caregivers.
This position reports to the Clinical Program Manager for ED/Inpatient Care Coordination in the Department of Psychiatry.PRINCIPAL DUTIES AND RESPONSIBILITIES:
SKILLS & COMPETENCIES REQUIRED:
EXPERIENCE:
Bachelor's degree preferred, Bachelor of Social Work or comparable training highly desirable
At least 2 years of work experience in the mental health care field preferred
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