PURPOSE STATEMENT: Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care for patients and their benefit/resource utilization.
Respond to inquiries about the facility within facility policy timeframes. Ability to develop therapeutic relationships with patients and families. Perform benefit eligibility to ensure patient benefits are active at the time of admission. Communicate benefit eligibility to the business office and the patient or significant other. Collaborate with facility medical and psychiatric personnel to ensure appropriate recommendations regarding pending referrals. Coordinate admission and transfer from referral sources and between levels of care within the facility. Maintain knowledge of milieu management. Communicate projected admissions to designated internal representatives promptly. Ensure all clinical information from referral sources or patients (including medical comorbidity information) is received, when possible, prior to patient admission. Schedule (when applicable) and complete pre-admission assessments, consult with the admitting physician and communicate disposition recommendations to the patient or their family. Possess skill in preparing and maintaining appropriate medical record documentation that will result in authorization at the level of care being requested of the payor. Complete initial pre-authorization for treatment and admission prior to admission, when possible, and within payor timeframe guidelines. Admit the patient to the registration and accounting system.
Complete all admission and consent forms with the patient. Demonstrate a positive, empathetic, and professional attitude toward customers always. When patient needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority. When a patient’s needs are not met, acknowledge and work to resolve complaints.
Recognize that patient safety is a top priority. Coordinate care for patients who are not being admitted and ensure that they receive appropriate follow-up care and referrals. Demonstrate a sense of urgency related to the importance of patient safety and provide excellent customer service. Responsible for conducting safety checks and ensuring that supervision is conducted at 15-minute intervals, as noted in special precautions, or by individualized supervision guidelines as needed. OTHER FUNCTIONS: Perform other functions and tasks as assigned. EDUCATION/EXPERIENCE/SKILL
Bachelor’s degree in a social services field required (if state allows). Master's degree in a social services field (psychology, counseling, social work, sociology, health administration, nursing) or RN preferred. One or more years’ experience in mental/behavioral health working with individuals in a clinical or observational capacity preferred. LICENSES/DESIGNATIONS/CERTIFICATIONS: Current licensure, as preferred for the area of clinical specialty, as designated by the state in which the facility operates. CPR and de-escalation/restraint certification required (training available upon hire and offered by facility). First aid may be preferred based on state or facility. ADDITIONAL REGULATORY
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g. emergencies, changes in workload, rush jobs, or technological developments) dictate. We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.