Admissions Utilization Management Coordinator, Crisis
Admissions Utilization Management Coordinator, Crisis
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Job Description
Make a Difference in Someones Life!
At Monarch we work together to provide life-changing care in communities across North Carolina and Rhode Island. As a team we provide hope promote wellness and empower individuals and families impacted by mental illness substance use disorders intellectual and developmental disabilities and traumatic brain injury.
You Belong at Monarch
You deserve a positive and encouraging work environment - a place where you can do your best work and grow as a professional. That is just what youll find at Monarch. Here we care for people including our team members. We offer a comprehensive competitive benefits package that supports full-time and part-time team members and their families. More than just a job this opportunity with Monarch will give you room to spread your wings and grow because we believe in promoting from within and developing future leaders.
Job Highlights:
This Opportunity:
The primary responsibility of this position will be to review and summarize referrals for admission to the Facility-based center including ensuring authorizations are in place prior and during the length of stay.What Youll Do:
Serves as the initial point of contact for all individuals in the community interested in a facility-based service. Effectively communicate with referral sources.
Enter screening and referral information in the electronic health record system.
Generate initial referral information about the youth and facilitate completion of supporting documentation. Present summary to the Interdisciplinary team for determination decision. Follow up with referral source on outcome of determination decision.
Completes prior authorization within identified timeframes. Assembles information to establish medical necessity using clinical information contained in the electronic health record system to justify initial and continued service for the youth at the FBC to payors as required. Makes recommendations to the Interdisciplinary team if services are not likely to be authorized prior to end date.
Attend and actively participate in meetings and training as required. Complete documentation in EHR as required. Maintain current licensure and certification in all agencies state and federal training requirements.
Completes record audits for adherence to Service Definitions UM Guidelines DHSR and Accrediting bodies.
Demonstrate knowledge of and comply with all agency policies and procedures as well as state and federal statutes and regulations related to specific program areas.
Demonstrate knowledge of emergency procedures and assist in crisis situations.
Participate in on call and afterhours coverage including weekends and holidays as needed.
Complete all other relevant responsibilities as assigned by the supervisor.
Driving and travel may be required.
Education Were Looking For:
Bachelors: Human Services (Required)Certifications Were Looking For:
Experience Were Looking For:
Schedule:
This is a PRN position. Shift coverage on an as-needed basis.Target Weekly Hours:
0Monarch is an Equal Opportunity Employer
Monarch offers opportunities as diverse as the people we support and the communities we serve. Monarch is an equal opportunity employer and we are firmly committed to supporting and celebrating all forms of diversity.
Monarch does not accept paper person with a disability who needs any reasonable accommodation under the Americans with Disabilities Act to apply for a position or otherwise to participate in Monarch job search or selection process should contactor call .
This job description in no way implies that these are the only duties and responsibilities to be will be required to follow any other instructions and to perform any other duties and responsibilities upon the request of a job description is subject to revision at the discretion of Monarch.
Required Experience:
IC
Employment Type
Part-Time
