Patient Access Manager

About the role

The Patient Access Manager at Conexiones is an essential member of the organization that focuses on an open access model. The Patient Access Manager is responsible for conducting critical processes related to referrals intakes census and client services. The Patient Access Manager will be responsible for overseeing incoming external internal and self-referrals; maintaining census at capacity; and ensuring the MAT process and medication management are complete before the clients intake. The Patient Access Manager will work closely with the Conexiones Program Director Chief Operating Officer Chief Clinical Officer and external providers to ensure incoming patients meet eligibility criteria. This process includes quality assurance tasks such as ensuring the processes of intake and admissions are being followed waitlists are up-to-date beds are filled referral/application data is entered reviewing documents to ensure all necessary information is obtained and uploaded checking insurance eligibility and communicating with the referral source.

Following Casa Esperanzas integrated care model the Patient Access Manager will communicate admission information and complete referrals to other Casa Esperanza services for which the client may qualify. Supports vulnerable patient populations (recently incarcerated recently homeless in need of withdrawal management and stabilization lacking insurance) in accessing culturally competent evidence-based and patient-centered trauma-informed care. All documentation will be stored in Evolv our electronic health record and billing database. This position will work with or report directly to the Director of Patient Access and the Conexiones Program Director.

The Patient Access Manager will provide supervision of patient access at the Tewksbury campus and ensure a seamless cohesive workflow with the rest of the Patient Access Department. Key areas of responsibility include quality assurance of all clients charts enforcing confidentiality and providing a safe environment for all staff and clients.

What youll do

Intake Responsibilities:

• Build and maintain relationships with internal and external referral sources
• Maintain awareness of current census and caseload targets and expectations
• Ensure timely access to services and work with clinical team to remove barriers to care
• Oversee initial assessment and follow-up care with internal and external providers to ensure timely access to services and operations for a dynamic open-access integrated care clinic including ASAM biopsychosocial and Urgent Care Triage as needed
• Identify individuals in crisis and engage clinical team for crisis response
• Manage communication and coordination amongst internal and external providers to ensure timely access to care including the prioritization of high-risk/high-need clients
• Manage Patient Access Conexiones
• Maintain and update any admission documentation required by Casa Esperanza or licensing agencies in a complete and accurate manner
• Serve as a resource for resolving problems related to registration demographic and insurance errors and verify insurance eligibility
• Adhere to all HIPAA and 42CRF laws following all confidentiality and protected health information regulations
• Ensure data entry and scanning of all referrals intake and other pertinent documentation into Evolv.
• Implement BSAS and Medicare regulations and process
• Ensure completion of BSAS Intake and Enrollment Assessment in patients electronic health record
• Review client records for completeness of client insurance information and proper signature
• Manages MAT for patients coming in to care including dosing letters identification and communications with home clinics
• Coordinates guest dosing orders with patients home clinics in accordance with guest dose procedures.
• Work collaboratively with the Program Manager on daily weekly and monthly occupancy reports.
• Other duties as assigned.

Clinic Operations

• Work closely with the Conexiones Program Director to ensure an exceptional level of service is delivered to all Casa Esperanza clients
• Work closely with the Patient Access Manager at Roxbury Residential Programs to ensure that meet all licensing regulatory accreditation and funder standards and requirements
• Coordinate to ensure room utilization system that will effectively support the growing need of the program
• Respond to internal and external data collection and reporting requests
• Ensure the Conexiones facility is in compliance with BSAS DPH and CARF requirements
• Function as an Evolv super-user to support direct care staff
• Other duties as assigned

Staff Supervision

• Provide weekly or biweekly individual and team supervision to Patient Access Coordinator Patient Access Clinician and Outreach and Referral Liaison
• Perform and monitor all personnel functions of the department subject to established departmental personnel policies and in consultation with the Director of Patient Access and Director of Human Resources

Qualifications

• Bachelors or Associates degree in social work psychology counseling or related field required. Degree may be substituted for LADAC/CADAC
• English/Spanish Bilingual required
• Knowledge in Eligibility Verification and Authorizations based on payer requirements
• Experience working with marginalized communities
• Strong verbal/written communication
• Ability to work as both an effective team member and independently
• Ability to meet the physical requirements and training requirements of the position
• MassHealth Certified Application Counselor or willing to obtain certification on the job
• Supervisory experience

Schedule

• Full-time onsite Monday-Friday 9am - 5pm

What we offer:

Casa Esperanza Benefits Package:

• Compensation: $58000 - 60000.00
• 401(k) Retirement Plan: All eligible employees may elect to participate after 1 year of service. Casa Esperanza Inc. will match a contribution of up to 6% of your annual salary
• Holiday Pay (12 days per year 1 floating holiday)
• Paid Time Off (PTO) - 18 days year one 20.5 days at year two 23 days at year five
• Sick Pay - 10 paid days per year
• Long/Short-Term Disability
• Paid by Company Life Insurance
• Health Insurance (Medical Dental Vision)
• Health Reimbursement Arrangement (HRA)
• FSA/DCA (Flexible Spending Account & Dependent Care)
• ComPsych Guidance Resources - EAP
• Educational Opportunities
• Tuition Remission
• Employee Ticket at Work (Discounts for Entertainment travel movies etc.)
• Career Advancement Opportunities
• Increased Salary for Credentials
• and more...

Physical & Mental Requirements

While performing the duties of this job the employee is regularly required to walk stoop kneel crouch or crawl and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include distance vision peripheral vision and depth perception.

At Casa Esperanza Inc. the health and safety of our people is our number one priority. Thats why all offers of employment are contingent on the candidate showing proof of being fully vaccinated against COVID-19 (currently one dose of the Johnson & Johnson vaccine or two doses of the Pfizer or Moderna vaccine and a booster when eligible) to pass the pre-employment requirements. Individuals with medical issues or religious beliefs that prevent them from getting the vaccine may request an exemption from the vaccine requirement.

Casa Esperanzas EEO Statement

Casa Esperanza Inc. values its diverse workplace and encourages women people of color LGBTQIA individuals people with disabilities members of ethnic minorities foreign-born residents older members of society and others from minority groups and diverse backgrounds to apply.

We recruit hire employ train promote and compensate individuals based on job-related qualifications and abilities. Casa Esperanza Inc. also has a longstanding policy of providing a work environment that respects the dignity and worth of each individual and is free from all forms of employment discrimination including harassment because of race color sex gender age religion or religious creed national origin ancestry citizenship marital status sexual orientation gender identity gender expression genetic information physical or mental disability military or veteran status or any other characteristic protected by law. All employees interns volunteers and contractors of Casa Esperanza Inc. are responsible for maintaining a work culture free from discrimination and harassment by treating others with kindness and respect.

Casa Esperanza Inc. also provides reasonable accommodation to qualified individuals with disabilities or based on a sincerely held religious belief in accordance with applicable laws. If you need to inquire about an accommodation or need assistance with completing the application process please email.

Required Experience:

Manager