Affiliate Relations Specialist I at Health Affiliates Maine LLC

Description

Health Affiliates Maine has an opening for an Affiliate Relations Specialist I to join their team! This is a full-time, hourly (non- exempt), role.

Roles and Responsibilities:

• Complete timely preliminary clinical audits using the Audit tool to be reviewed by the Assistant Director (this includes tracking audit completion and timelines, uploading paperwork/interaction log and providing affiliate correspondence).
• Support the mentoring program by providing administrative support to related notifications, consultants etc.
• provide welcome emails to new affiliates.
• Complete affiliate check-ins related to inactivity per Inactivity procedure.
• Review substance use qualifications report and notify affiliates that need to submit compliance documents (copying the Assistant Director).
• Tracking supervision documentation and reminding affiliates, bringing noncompliant affiliates to the Assistant Director.
• Complete the 90-day discharge report and first notifications to affiliates.
• Complete random audits on medical necessity measures on affiliate records using Medical Necessity template.
• Using the knowledge library and other templates, research and respond or ensure response to affiliate inquiries sent by phone, voicemail, electronic health record, email and/or ticketing system, forwarding those that need clinical response to the Assistant Director.
• Submit critical incident and mandated DA reports provided by affiliates in designated system.
• Provide courtesy calls to affiliates as needed per procedures (such as when an affiliate is late or overdue on items).
• Prepare/Support completion of the weekly update for Assistant Director to publish weekly to the affiliate hub.
• Provide administrative support on Affiliate relations projects, including minute taking when needed.
• Check references as needed for conditional affiliate applications.
• Coordinate meeting links and minutes as requested.
• Participating in EHRYW change and improvements as relevant to affiliate role.  
• Participate in marketing activities for the affiliate program as requested by leadership.
• Provide back up to the Program Integrity department on continued stay reviews or discharges. (Complete a few each week to maintain competency).
• Document interactions with affiliates as directed by department leadership or applicable policy/procedure.
• Provide affiliate relations support for other HAM departments (billing, operations, program integrity, case management, referrals/reception, human resources, leadership, clinical support) as indicated by department leadership and/or policies and/or procedures/workflows.
• Assist the Assistant Director with completion of affiliate contract evaluations, completing the first portion of review.
• Assist with Affiliate-focused projects interdepartmentally as requested (such as those related to enhancing the E.H.R. referrals or other processes).
• Maintain and apply knowledge of MaineCare, Contracting, Licensing, and affiliate contractual obligations to HAM for the populations served by our affiliates.
• Understand the basics of billing and MaineCare authorization (Acentra) processes to assist affiliates in understanding policies and procedures related.
• Be prepared for and actively participate in meetings with your supervisor, department and agency wide.
• Protect and maintain the confidentiality of client records and information, following HIPAA, HITECH regulations and 42 CFR.
• Log/Maintain records of affiliate interactions and complete other forms, paperwork when necessary or per department procedures.
• Attend and participate in clinical and administrative supervision and training as prescribed by your certification and/or license and Health Affiliates Maine.
• Participate in offerings to our affiliates, such as training and the Consortium.
• Maintain knowledge of the Rights of Recipients of Mental Health Services and the AMHI Consent Decree.
• Practice a trauma-informed approach to care including maintaining a calm, non-defensive attitude to de-escalate crisis situations, encouraging the health, safety, and welfare of clients, and ensuring self-determination.
• Participate in mandated reporting per agency policy and Maine Law including the review and submission of critical incidents, reportable events, and DA reports.
• Complete all other duties assigned by leadership and supervisor.

Requirements

Minimum Education/Experience Qualifications:

• A bachelor's degree in social work, Psychology, or related field 
• Active MHRT-C, LSW or CADC credential/licensure
• At least 2 years of clinical administrative experience at a behavioral health organization