Residential Admissions Coordinator - Perimeter Healthcare

Jackson, TN 38305

About the Job

Perimeter Behavioral of Jackson has immediate openings for Residential Admissions Coordinator. We are seeking individuals who are committed to improving the lives of those with mental health illness as we expand our growing company!

Perimeter Behavioral Hospital of Jackson is a behavioral health treatment facility providing care to adolescents. Located in Jackson, TN, Perimeter Behavioral of Jackson's goal is to provide a responsive healing environment for patients and to inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education, and compassion. Join our professional team today.

JOB TITLE: Residential Admissions Coordinator

SERVICE AREA: Clinical Services

A.        POSITION SUMMARY: The Residential Admissions Coordinator is responsible for receiving referrals for the Residential Program, providing a clinical review and subsequent acceptance and denial (with reason) for each referral. Once a referral has been accepted, the position is responsible for coordinating admission. This is done through communication and collaboration with the Residential Services Business Development Team, resident’s key stakeholders, and resident’s insurance company. The position is responsible for ensuring the Residential Program remains in compliance with all HIPAA, JACHO, CARF and other states/contract licensing guidelines and standards for the above areas. This position is responsible for tracking referral calls, assessments and admissions as well as the evaluation of this data for the purpose of departmental improvement. Additionally, this position serves as the utilization management point of contact and submits prior authorizations for level of care, as well as continued stay review information for concurrent authorizations.

B.        SUPERVISOR: Director of Clinical Services; will report to CEO for UM related needs

C.        PERSONNEL SUPERVISED: None

D.        WORK DAYS/HOURS: The regular work week is Monday through Friday, 9:00 a.m. to 5:00 p.m.; however these hours may be flexed or extended as needed to fulfill job duties.

E.         REQUIRED KNOWLEDGE, SKILLS, AND EDUCATION:

Master’s Degree in the mental/behavioral health/related field, license required. Registered Nurse (RN), is also acceptable with extensive background in child/adolescent treatment facilities. Experience in customer service, strategic planning and sales/marketing also preferred, but not required.

2. Typing skills, computer experience, strong organizational skills, communication skills and ability to perform detailed work.

Ability to use the English language and medical terminology effectively and to understand/carry out complex oral and written instructions within a prescribed routine.

Knowledge of Utilization Management and medical necessity strongly preferred.

Knowledge of the principles of clinical treatment and social casework of children, adolescents, and families in a mental health setting.

Knowledge of the referral, assessment and admissions processes, including admission criteria, clinical requirements to secure insurance authorization and facility based milieu issues that impact admissions.

Knowledge of HIPPA, JCAHO, CARF, and other various state licensing and service contract standards of care.

F. PERFORMANCE EXPECTATIONS

1. Direct the response to request for services, including the initial response, the assessment and referral process, the designation of appropriate level of care, initiating of services, and follow up activity.
  1. Review the effectiveness of the comprehensive interface with external reviewers, communicate with external reviewers and managed care organizations to assure timely and appropriate interactions, monitor outcomes of reviews and provide consultation as needed.
  2. Review the quality of documentation provided to assure adequacy and clinical appropriateness.
  3. Advise and assist all departments/services and committees accountable for performance improvement activities.
  4. Maintain a record of all completed reviews, evaluations and process improvement team activities.

1. Demonstrates the ability to maintain a safe work environment by following safety practices within the center and immediately reporting any safety concerns/issues to the Director of Plant Operations and/or Quality Risk Director.

1. Demonstrates the ability to perform the pre-admission process, including but not limited to assisting co-workers, case workers, families/guardians, and referral sources with the referral processes; phone calls; referral source communication; verification of benefits; copying, filing, faxing and mailing of confidential documents.

1. Communicates effectively and takes inquiry calls from families, social services, employees and residents; and then directs them to the appropriate entity. Acts as a liaison between families, referral sources and all Perimeter Behavioral Health disciplines in problem solving.

1. Demonstrates the ability to maintain a productive, professional, and positive work atmosphere by behaving, interacting, and communicating in a manner that promotes cooperation and teamwork with co-workers, supervisors, referral sources, families and residents.

1. Demonstrates the ability to verify benefits with the insurance company, interpret insurance information for the family and facility. Communicate intake information to the facility for evaluation, treatment planning and discharge planning.

1. Demonstrates the ability to act as a liaison between referral development staff, families, referral sources and other Perimeter facilities.

1. Demonstrates the ability to work closely with the CEO, Medical Directors, and Clinical Directors to determine the appropriate level of care and placement needs of potential residents.

1. Demonstrates the ability to provide treatment alternatives to referral sources when placement into Perimeter is not appropriate.

1. Demonstrates the ability to adhere to all policies and procedures to include code of ethics, confidentiality, patient rights and educational requirements.

1. Demonstrates the ability to conduct other duties as assigned.

Source : Perimeter Healthcare