Step-Down Patient Care Navigator

UHS•West Columbia, SC

3d•Onsite

About The Position

Three Rivers Behavioral Health is a 136-bed treatment facility that specializes in quality behavioral health and substance abuse services for adolescents and adults. We offer a full continuum of care through an integrated system of inpatient, partial hospitalization and intensive outpatient programs. Conveniently located between I-20 (Exit 61) and I-26 (Exit 110) in West Columbia, SC, our team of 300+ high quality employees describe working here as "family atmosphere," "supportive leadership," and "life-changing." Progressive professionals in the fields of psychiatry, medicine, nursing, social services, and activity therapy serve hundreds of adults and adolescents each month with the common goal of creating new beginnings. Healthcare professionals have a unique opportunity to affect lives for the better each and every day. Choose Three Rivers and start your life-changing journey today. The Step-Down Navigator is responsible for meeting with all eligible patients to discuss the benefits of Outpatient services as part of their continuum of care treatment. The Step-Down Navigator will be responsible for communicating eligibility to key members of senior leadership & associated departments and will be responsible for routinely collecting and entering data, specific to Outpatient eligibility, into Midas for trending report purposes. This position will have a thorough understanding of the Step-Down Playbook, implementing components of the Playbook as needed. A thorough understanding of the Inpatient workflow process, as it pertains to case management and discharge planning, is preferred.

Requirements

Bachelor's degree in social work, psychology or related field.
Minimum of 2 years experience in behavioral health.
CPI certification (provided upon hire).

Nice To Haves

Masters' degree strongly preferred.
A thorough understanding of the Inpatient workflow process, as it pertains to case management and discharge planning, is preferred.

Responsibilities

Consults with Social Services, Utilization Management and Outpatient on patient eligibility.
Maintains current awareness of Outpatient programming.
Ensure the Step-Down process is maintained to provide continuity of care.
Maintains Midas data collection process.
Identifies and communicates data driven trends in the step-down process.
Assist in the development of strategies, goals and objectives related to the step-down process.
Consults with facility management, ensuring awareness of step-down trends.
Utilization management to include participating in pre-certifications for admissions with third party payers.
Completes Pre-Authorization for Outpatient Services.
Performs concurrent reviews for patients to ensure that extended stays are medically justified and are documented in the patient’s medical records.
Prepares and submits appeals to third party payors within required timeframe.