SMA Careers >> Patient Care Coordinator; Full Time
Patient Care Coordinator; Full Time
Summary
Title:Patient Care Coordinator; Full Time
ID:4676
Department:Adult Outpatient Services
Location:1220 Willis Avenue, Daytona Beach, FL 32114
Description

Working Hours: 40 hrs week; Mon-Fri
Non-exempt
 
A Patient Care Coordinator provides a professional review of clinical services and staff’s clinical activities via the client record to assure that client placement and service delivery complies with the compliance and admission standards of SMA. The position primarily focuses on receiving calls from individuals inquiring about behavioral health services at SMA.  The Patient Care Coordinator will be responsible for providing service education, referrals to services, program information, and immediate linkage and admission to appropriate SMA services.  The Patient Care Coordinator will obtain insurance verification for clients who are admitting to inpatient and outpatient services and enter that information into the Avatar EMR system. When necessary, the Patient Care Coordinator will obtain pre-certification and obtain authorizations for third party payment of SMA treatment services for clients who have insurance.  The Patient Care Coordinator will assist in the review of client records for tracking and auditing purposes as well as other issues of compliance with SMA services standards, CARF requirements, state licensure, Medicaid and other quality improvement standards as assigned by the department supervisor.  Patient Care Coordinator will also provide crisis response via telehealth when needed to clients in various programs including medication assisted treatment and crisis response team.

Qualifications

At Minimum a High school Diploma and 4 years of direct care experience working in the Human services or related field.  Graduation from an accredited school with a Bachelor degree in Human Services or a related field or a Master’s Degree or Certified Addictions Professional (CAP) is preferred and can substitute for up to 2 years of work experience. Experience with American Society of Addictions Medicine Patient Placement Criteria is preferred. Experience with CARF, Medicaid, and Managed Care requirements is preferred.
  • Proficiency in working with telephone system and telephone etiquette.
  • Must be knowledgeable and demonstrate competency in current best practices of behavioral health treatment and related services, especially as it relates to documenting the course of treatment and patient placement criteria in the client record.
  • Depending on assignment must have knowledge of typical diagnoses, treatment services, and developmental issues for adolescents in general, delinquent adolescents, adults and pregnant/post-partum women who are admitted to a mental health and/or substance abuse treatment setting.
  • Demonstrates proficiency with assigned client populations in performing utilization reviews in records of clients with specific problems and needs.
  • Knowledge of the services provided at SMA at the various locations and able to correctly direct callers to the correct service.
  • Proficiency in working with computer hardware and software, when assigned.

Responsibilities
  • Completes calls from individuals inquiring about services, who are in need of immediate assistance, admitting to services, need information regarding services and community resources and linkage to SMA behavioral services.
  • Responds to requests from hospital emergency department(s) to connect via telehealth with clients and provide information and education about recovery and Medication Assisted Treatment
  • Provides information on Baker Act and Marchman Act
  • Serves as back up for the Crisis Response Team’s in office triage and dispatch
  • Provides solution focused supportive counseling and linkage to individuals that need immediate services
  • Collect demographic and insurance data, register new clients for services, verify insurance
  • Eligibility and benefits and enter financial eligibility and authorization data in our Avatar EMR system.
  • Conduct authorization reviews with insurance companies for clients admitted to services.
  • Notify staff of insurance authorizations through email and/or phone calls notifying them of authorization and insurance company expectations for the next review.
  • Improves professional knowledge and skill base relevant to utilization management by attending seminars, trainings, and conferences and by reading current literature.
  • Participates in required SMA in-service trainings to maintain employment.
  • As assigned, assists in the maintenance of SMA's compliance with treatment and documentation requirements of funding sources, performance improvement, and accreditation activities.
  • When assigned or review requires it, coordinator is knowledgeable of up to date standards/criteria of ASAM PPC, Medicaid, a particular MCO, DCF, and CARF.
  • Makes commitment to SMA’s mission and core values the SMA Way
  • Abides by principles of EEO compliance and a workplace of dignity and respect.
  • Works cooperatively in a group/team setting.
  • Shows respect to others.
  • Takes guidance and direction from supervisors.
  • Arrives/Reports to work on time and ready to work.
 
SMA Healthcare is a tobacco and drug-free workplace.
EEO Employer     W / M / Vet / Disabled
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