Outpatient Coordinator - Behavioral Health

UHS•Aiken, SC

About The Position

Outpatient Care Coordinator – Aurora Pavilion Behavioral Health Aiken Regional Medical Centers, located in Aiken, South Carolina, is a 273-bed acute care facility providing top quality and safe healthcare to the residents of Aiken and surrounding communities since 1917. Aiken Regional Medical Centers has been ranked a top hospital in South Carolina by the American Heart Association for its treatment of heart attack, heart failure and Stroke, and most recently, coronary artery disease. Additionally, Aiken Regional provides comprehensive healthcare services such as behavioral health (Aurora Pavilion Behavioral Health), emergency medical care (main hospital and ER at Sweetwater), orthopedic surgeries, maternity, rehabilitation services(Hitchcock Rehabilitation Services), imaging, and wound care. Visit us online at: https://www.aikenregional.com The Outpatient Care Coordinator provides quality case management and psychotherapeutic services to adult patients dealing with psychiatric and/or addiction issues; to serve as a member of interdisciplinary team supporting the organization's treatment program and philosophy and assure the deliverance of quality treatment to patients and their families. Perform Service Excellence at all times.

Requirements

Education: Master’s degree in Social Work or equivalent Master’s Degree in a Mental Health Field.
Experience: At least 1 year of experience working with patients with addiction or other psychiatric issues.
License or Registration Requirements: SC State licensure preferred.
Training: CPI Training required within 90 days of hire.

Nice To Haves

SC State licensure preferred.

Responsibilities

Develops and maintains effective working relationships with NARC, Admissions, the Business Office, Physicians, and Nursing staff
Conducts psychosocial assessments to document history and identify preliminary issues for treatment focus by interviewing the patient and their family members.
Psychosocial are completed in a timely manner and the data is comprehensive.
Demonstrates skill in establishing rapport with patients who are violent, evasive, deceptive, or otherwise resistant to treatment.
Provides group process-oriented therapies as well as conducts educational and other didactic groups for patients using various professional treatment modalities.
Develops and coordinates an individualized discharge plan for the patient by utilizing treatment team and chart information to determine the patient's aftercare needs. Identifies and assesses family or community resources such as community residencies, group homes, or mental health practitioners to meet patient's aftercare needs.
Initial discharge plan formulated and noted on psychosocial with 72 hours of admission.
Routinely updates and documents discharge transition efforts with respect to discharge status, discharge planning referrals/assistance, services provided, aftercare plan and recommendation.
Contacts and makes arrangements with outside agencies for smooth transition from organization. Copies are faxed within designated time frame and confirmation is placed in chart.
Attends regular treatment team meetings to provide social work perspective to total case management of the patient by reading and discussing progress notes from charts and communicating any state or local agency legal requirement for case management with the interdisciplinary team.
Demonstrates ability to modify or customize standard treatment interventions to maximize clinical outcomes.
Reports to community/state agencies any patient issues required. Documents report in patient's chart. Conducts follow-up calls with protective agencies; assists agency in obtaining necessary information.
Demonstrates understanding of group process and group dynamics.
Demonstrates knowledge of current treatment methods and age specific communication skills.
Progress notes are timely, neat, concise, and thorough and contain all relevant information.
Manages time and workload efficiently while demonstrating self-motivation to seek work that needs to be completed
Successfully completes all required trainings via in services and/or Health stream, CPI & licensure, in a timely manner.
Assists with orienting/training staff in a proactive manner
Performs chart reviews (daily concurrent and retrospective, as necessary) for private insurance population in order to certify inpatient admission and continued stay days.
Performs concurrent chart review for Medicare, Medicaid, and self-pay population for justification of inpatient admission and continued-stay.
Enters results of all utilization reviews for all pay sources into SMS, and eventually, into MIDAS+ system.
Regular “fax and phone” relationship with insurance companies.
Phones insurance companies to obtain authorization of final days certified if not otherwise obtained concurrently.
Regular collaboration with patient caregivers/physicians when documentation does not reflect need for acute hospitalization in order to reduce avoidable hospital days.
Identifies and documents avoidable hospital days according to defined criteria and takes appropriate intervention as necessary.
Provides trending of avoidable inpatient days according to physician, dept., reason, diagnosis, and pay source.
Provides documentation and monthly trending of actual and potential hospital days saved by various QOM department service lines.
Tracks and trends insurance company denials according to company, physician, and reason.
Tracks results of hospital appeal of denied insurance days and trends by insurance company.
Maintains log of HINN days certified and Medicaid administration days.
Responsible for the organization and implementation of Quarterly Utilization Review Committee, documents minutes of meetings and uploads minutes to UHS SharePoint.
Provides education to nursing and medical staff regarding efficient utilization of hospital days and resources.
Identifies and makes referrals to Discharge Planning, Infection Control, Case Management, and Peer Review as appropriate.
Collaborates with Medical staff and other departments as appropriate to facilitate development of clinical practice guidelines for designated patient groups.
Participation in occasional travel to attend educational opportunities or other hospital related activities.
Completes monthly chart Audits. (Medicare Specific)
Responsible for the management of SC DMH State funding request and re-certification request. Maintaining records for follow-up and communication with Finance Department at ARMC
Responsible for the monitoring for completion and compliance of Medicare Certifications and Re-Certifications for both inpatient and PHP/IOP services lines.
Provides back-up assistance with assessments in the Needs Assessment area on a routine basis.
Other duties as assigned