Clinician, Central Access Team
Location: East Longmeadow
Posted on: January 24, 2023
This position is responsible for maximizing access to inpatient
behavioral health care and patient movement for the Department of
Behavioral Health. Admissions for our Inpatient Behavioral Health
beds require the ability to form relationships with area hospitals,
emergency rooms, nursing homes and providers, timely and efficient
responses to requests for beds, coordination with medical staff,
and the ability to present cases concisely while covering important
clinical detail. This position works in collaboration with Director
of CAT, Nurse Managers, Crisis Services, and Utilization Review.
Responsible for patient movement across the system. Assists with
verification of benefits, and prior authorization for services to
ensure payment with perspective insurance companies. Develops a
working knowledge of the various payers' admission criteria to
ensure that the requirements for pre-certification are met. Works
with prospective patients, families, and referring professionals.
Works to maximize access to services across the inpatient BH
service line. Provides extraordinary customer experience,
understands needs of callers and breadth of service in our system
of care. Has a high level of understanding of available resources
within the Behavioral Health continuum of care locally, regionally,
- Master's Degree and licensed/certified in a Behavioral Health
field is required.
- Minimum of ten (10) years of experience in the Behavioral
Health field with Utilization Review required.
- Must have experience in caring for those with mental health,
substance use, and co-occurring disorders.
- Requires experience with benefit verification, eligibility,
pre-authorizations, and admission criteria.
- Must have excellent verbal and written communication skills to
effectively communicate with and be responsive to medical staff,
referral sources, patients, family, and a multitude of other
customers who interface with areas of responsibility.
- Requires experience working with and understanding
hospital-based inpatient behavioral health care.
- Must have experience working with managed care and
understanding of prior authorizations and utilization review.
- Must be familiar with requirements to meet hospital level of
care, including basic symptomology, required labs, importance of
obtaining medication reconciliations, and accepting appropriate
ESSENTIAL DUTIES and RESPONSIBILITIES:
Disclaimer: Job descriptions are not intended, nor should they be
construed to be, exhaustive lists of all responsibilities, skills,
efforts or working conditions associated with the job. They are
intended to be accurate reflections of the principal duties and
responsibilities of this position. These responsibilities and
competencies listed below may change from time to time.
- Coordinate admission and transfer between levels of care within
- Communicate projected admissions to designated internal
representatives in a timely manner.
- Maintains optimal census across all units.
- Establishes positive working relationships with community
referral resources to increase admissions to behavioral health from
- Perform insurance benefit verifications and prior authorization
- Ensure all medical admission documentation is gathered from
external sources prior to patient admission.
- Assist crisis services with prior authorization when time
allows to facilitate timely patient throughput.
- Review clinical data and determine appropriate level of care
for patient after consulting with the attending physician.
- Completes an intake form, documenting patient's clinical
information and disseminates to the interdisciplinary treatment
- Contacts Utilization Review clinician with authorization and
follow up reviews.
- Assists crisis services with referring outside of system to
find appropriate beds when time allows.
- Understands the balance between service area admissions and
outside admissions in order to maximize provision of care for
behavioral health patients.
Keywords: ECHN, Springfield , Clinician, Central Access Team, Other , East Longmeadow, Massachusetts
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