Mental Health Clinical Services Coordinator en Access Group, Inc.

Description

POSITION PURPOSE

Initiates and maintains direct communications with outside agencies related to clinical care coordination. Completes prior authorization requests for mental health services. Responds to retrospective review audits for mental health services. Works closely with professional staff for client monitoring and coordination of services.

ESSENTIAL FUNCTIONS & BASIC DUTIES

1. Responsible for setting up caseload assignments, initial referrals and holder PAs for new clients in the electronic system when a diagnostic appointment has been scheduled. Ensures caseload lists and ongoing referrals are updated as needed. 

2. Processes all diagnostic intakes and treatment plans by entering key dates for tracking and uploading documents into the electronic system. Ensures originals are filed appropriately.

3. Coordinates completion of treatment plan reviews by applicable deadline and creates calendar invites as reminder for the clinicians.

4. Ensures treatment plans and treatment plan reviews are signed by the Psychiatrist timely and reprocessed.

5. Submits and monitors initial and ongoing mental health prior authorization requests to Atrezza and Medicaid PASSEs. Enters approvals in the electronic system, requests extensions or modifications as needed, and ensures final determinations are uploaded and filed in the client’s chart. Collaborates with clinicians, the Director of Billing and Clinical Support, and/or the AERC Director to appeal denials or negotiate authorizations as needed.

6. Responds to all mental health retrospective audit requests. Provides requested information within required time frames. Works with individual clinicians, Director of Billing and Clinical Support, an/or Director of Clinical Operations to appeal all denials. Ensures all final determinations are filed in the client’s medical chart.

7. Collaborates closely with clinical and administrative staff for ongoing client monitoring and coordination of services, including referrals to the ACCESS Psychiatrist and Independent Assessment submissions. Assists with completing internal withdrawal forms for mental health services when appropriate.

8. Assists in managing the ACCESS Psychiatrist’s medication clinic by sending appointment reminders, supporting clinic-day operations, and processing documentation.

9. Performs utilization management reviews each week to monitor usage of approved units for ordered services.

10. Assists with completion of Performance Improvement initiatives including quarterly quality assurance reviews.

11. Assists with medical records requests for mental health documentation as needed.

12. Completes relevant and approved annual in-service trainings.

13. May perform other related and non-related duties, as assigned.  

COMPETENCIES

Initiative:

• Volunteers readily.
• Undertakes self-development activities.
• Seeks increased responsibilities.
• Takes independent actions and calculated risks.
• Looks for and takes advantage of opportunities.
• Asks for and offers help when needed.

Innovation: 

• Displays original thinking and creativity. 
• Meets challenges with resourcefulness.
• Generates suggestions for improving work.
• Develops innovative approaches and ideas.
• Presents ideas and information in a manner that gets others’ attention. 

Motivation:

• Sets and achieves challenging goals.
• Demonstrates persistence and overcomes obstacles.
• Measures self against standard of excellence.
• Takes calculated risks to accomplish goals.

Problem Solving:

• Identifies and resolves problems in a timely manner.
• Gathers and analyzes information skillfully.
• Develops alternative solutions.
• Works well in group problem-solving situations. 
• Uses reason, even when dealing with emotional topics. 

Planning/Organizing:

• Prioritizes and plans work activities.
• Uses time efficiently. 
• Plans for additional resources. 
• Sets goals and objectives.
• Organizes or schedules other people and their tasks.
• Develops realistic action plans. 

Teamwork:

• Balances team and individual responsibilities. 
• Exhibits objectivity and openness to others’ views.
• Gives and welcomes feedback.
• Contributes to building a positive team spirit.
• Puts success of team above own interests. 
• Able to build morale and group commitments to goals and objectives.
• Supports everyone’s efforts to succeed. 

PHYSICAL DEMANDS

While performing the duties of this job, the employee is frequently required to talk or hear. The employee is regularly required to walk; sit; use hands to finger, handle, or feel; and reach with hands and arms. The employee is occasionally required to stand and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

The noise level in the work environment is moderately quiet.

Requirements

QUALIFICATIONS

Education/ Certification:

• Bachelor’s Degree from a four-year accredited college or university preferred

Experience/ Knowledge required:

• One year of successful experience in a similar position or equivalent combination of education and experience. 

Skills/ Abilities:

• Ability to communicate effectively and professionally with a wide variety of people.
• Strong organizational skills with attention to detail and accuracy. 
• Basic computer skills which include a working knowledge of databases, word processing, spreadsheets, and Internet software. 
• Ability to handle multiple tasks in a very busy environment. 
• Ability to read and interpret documents such as safety rules, policies, and other company documents. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. 
• Ability to add, subtract, multiply, divide, in all units of measure using whole numbers, common fractions, and decimals. 
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. 
• Ability to deal with problems involving several concrete variables in standard situations. 

PHYSICAL DEMANDS

While performing the duties of this job, the employee is frequently required to talk or hear. The employee is regularly required to walk; sit; use hands to finger, handle, or feel; and reach with hands and arms. The employee is occasionally required to stand and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

The noise level in the work environment is moderately quiet.

TRAVEL REQUIREMENTS

• Minimal travel is required for this position; this travel should not include transporting students/clients.
• ACCESS drivers are required to maintain a valid Driver’s License, current auto liability insurance and registration, a clean driving record, and physical ability to drive to local locations throughout Arkansas.