Program Evaluation and Benefits Specialist

AltaPointe Health • Mobile, AL

2d

About The Position

This role involves providing benefits assistance to patients, ensuring accurate clinical documentation, and managing the benefits process, including denials and appeals. The specialist will also handle crisis intervention, collaborate with internal and external entities, and advocate for patients to secure community resources. Additionally, the position requires meticulous clinical record keeping using the Avatar electronic health record and participation in program evaluation, administrative duties, and data management for BHCC and grant-related projects.

Requirements

• High School diploma
• Knowledge of psychiatric and substance use disorders in the adult population and/or knowledge of addiction as a primary/secondary illness
• Knowledge of cultural diversity
• Knowledge of behavior management, crisis intervention and interventions common to acute psychotic patients, and/or patients with substance abuse issues as well as, to non-violent crisis intervention practice
• Knowledge of Psychiatric Rehabilitation principles and Substance abuse treatment principles
• Knowledge of available community resources
• Knowledge of Intellectual and Developmental Disabilities
• Knowledge navigating benefits and insurance providers
• Ability to obtain SOAR certification within one month
• Knowledge of billing and entry level accounting
• Knowledge of data collection methods, excel spreadsheets, analytic software
• Knowledge of rules and regulations regarding appropriate benefit entitlements such as social security, Medicaid, and Medicare

Responsibilities

• Responds promptly to requests to meet with patients for benefits assistance
• Provides prompt and accurate clinical documentation, ensuring completion of the benefits process including denials and appeals
• Demonstrates the ability to recognize the elements of a crisis state and knows how to deescalate or resolve the situation
• Effectively determines the level of response needed in crisis situations and refers to the appropriate clinician and level of care
• Transports patients to benefits appointments if necessary
• Collaborates with other members of AltaPointe programs to help with placement of patients in services when necessary
• Collaborates with outside entities in a professional and polite manner to ensure benefits process is followed to completion
• Follows up with patients who are in the benefits process or who may need extra assistance
• Travels to patients’ homes to provide follow up as needed
• Advocates on behalf of the patient to secure community resources
• Adheres to professional standards
• Effectively demonstrates the application of adult specific competencies
• Documents in a timely fashion per AltaPointe policy
• Learns and utilizes Avatar electronic health record and insure navigation tools appropriately
• Documents in detail the steps taken in the benefits process and linkage to appropriate follow up sources
• Documents all calls and services provided before the completion of the shift
• Documents case disposition, case closings, follow-up and referrals
• Documents legibly
• Treats patients with care, dignity and compassion
• Respects patient’s privacy and confidentiality
• Is pleasant and cooperative with others
• Assists patients as needed
• Is sensitive to the patient’s needs, expectations and individual differences
• Is gentle and calm with patients, families, and other agencies
• Enters BHCC and grant-related data into database daily so as not to fall behind, catches up promptly if off work
• Maintains data in a confidential manner, does not share data with unauthorized persons or entities
• Understands current data software and learns new software and tools as needed, seeks to contribute to continuous quality improvement
• Actively seeks ways to improve data collection, entry, and analysis
• Actively participates in Performance Improvement activities
• Completes assigned tasks in a timely manner
• Accesses appropriate community resources according to patient needs
• Follows AltaPointe policies and procedures
• Maintains current certifications and requirements for renewals, if applicable, and attends to required in-services and workshops
• Participates in ongoing staff education trainings
• Remains flexible, understanding that grant, DMH, and other data-related deadlines may alter scheduled daily activities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED