POSITION OPENING

COORDINATOR OF SERVICE UTILIZATION

JOB SUMMARY: The Coordinator of Service Utilization holds primary responsibility for Hospital Authorization (HA) operations and quality assurance. Duties include monitoring and ensuring proper execution of all HA functions, providing quality assurance feedback and performance evaluation for Care Managers , Inpatient Authorizers and HA Administrative Assistant plus meeting all Crisis Clinic and King County reporting requirements. The Coordinator maintains complete knowledge of all HA department functions and protocols and performs those duties as necessary. S/he ensures appropriate assignment of inpatient cases, tracks and troubleshoots problems internally and with inpatient facilities, outpatient treatment providers and County staff.

The Coordinator provides leadership beyond the HA department through interdepartmental collaboration with startup, time-limited and ongoing projects. Growth opportunities dependent upon skills possessed.

Splitting the position through job sharing may be considered upon request.

QUALIFICATIONS AND EXPERIENCE NEEDED:

· Masters degree in social sciences and two years supervised experience working with chronically and acutely mentally ill individuals.

· Mental Health Professional per Washington Administrative Code 388-865-0150.

· Strong assessment skills.

· Knowledge of the King County public mental health system.

· Experience with inpatient psychiatric hospitalization processes.

· Evidence of supervisory skills.

· Strong data entry skills and excellent written/oral communication.

· High attention to detail and thorough follow-through.

· Self-starting initiative.

· Prefer Child Mental Health Specialist per WAC 388-865-0150.

SUPERVISORY RESPONSIBILITIES, IF ANY: HA Care Managers and HA Inpatient Authorizers and HA Administrative Assistant.

POSITION REPORTS TO: Clinical Director.

SALARY: $40,000 - $44,000 annually. 37½ -hour workweek. Job-sharing optional.

TO APPLY: Send resume’ and cover letter outlining qualifications and experience to: Don Kuch, Crisis Clinic, 1515 Dexter Ave. N., #300, Seattle, WA 98109 or email to dkuch@crisisclinic.org

CLOSES: OPEN UNTIL FILLED

Crisis Clinic is an Equal Opportunity Employer.

JOB COMPETENCIES

PROGRAM TRACKING & OVERSIGHT 30%

1. Initiates and maintains positive and productive working relationships with peers, funding/contracting agencies, community providers, etc. in support of Crisis Clinic’s organizational goals.

2. Acts as operations coordinator with Medical Director and psychiatric subcontractor and as primary liaison to inpatient facilities and the County.

3. Ensures contract compliance and maintains on-going processes which provide consistent quality assurance.

4. Maintains broad knowledge of HA program operations as a means of providing direct support to staff, maintaining quality and accessibility.

5. Works with Quality Assurance and Crisis Line Coordinator and Clinical Director, ensuring efficient and effective integration with other Crisis Services Department programs.

6. Provides supervision and performance evaluation of HA department staff.

7. Identifies HA staffing needs, recruiting and hiring staff in coordination with Clinical Director and Crisis Line Coordinator.

8. Provides orientation and training to staff to establish and maintain competence and quality service provision.

9. Schedules HA department staff and maintains psychiatrist on-call schedule.

10. Assures full shift coverage and handles vacant shifts when necessary.

11. Ensures timely, appropriate assignment of inpatient cases.

12. Monitors care management of all cases.

13. Tracks, collects and presents data for reporting requirements.

14. Participates in program meetings and planning.

15. Develops, maintains and updates written policies and procedures.

HOSPITAL STAY COORDINATION 25%

1. Reviews authorization information, identifying, investigating and correcting any inaccuracies or inconsistencies found.

2. Generates certification or denial documentation.

3. Routes authorization certification and denial documentation to inpatient treatment facilities, meeting timeliness requirements.

4. Coordinates retrospective reviews by receiving review requests, gathering and disseminating documentation as necessary, coordinating with the Medical Director and/or King County and notifying appropriate parties of the final determination.

5. Makes length of inpatient stay, extension and administrative day determinations, based on patient diagnosis, medical necessity, treatment plan and other considerations, using clinical judgment and accessing psychiatric consultation as appropriate.

6. Tracks and monitors assigned cases during inpatient stay.

7. Coordinates discharge planning with inpatient facilities, facilitating involvement of outpatient treatment providers as appropriate.

8. Assists in appeals with appropriate data dissemination and information sharing.

9. Takes appropriate measures to ensure proper client confidentiality at all times.

10. Completes and maintains all required documentation and data entry.

AUTHORIZING 15%

1. Establishes and maintains thorough working knowledge of Adult and Child Level of Care Utilization Screening Systems (LOCUS and CLOCUS) and Crisis Clinic’s Community Resource System.

2. Answers the Hospital Authorization Line and/or responds back to the referring party in a timely and helpful manner.

3. Obtains all necessary eligibility, screening and assessment information from the referring party, discusses treatment plan including possible alternatives to hospitalization and coordinates diversion as appropriate.

4. Contacts the psychiatrist according to the on-call schedule for all adult authorization denials, child authorizations, child authorization denials and other situations as appropriate. Accurately and fully conveys all necessary information and confirms and records reasons for all denials.

5. Makes authorization and denial determinations based on medical necessity using screening guides, LOCUS and CLOCUS assessment tools, knowledge of WAC, County Policies and Procedures, alternative treatment resources and clinical judgment in consultation with psychiatrist as necessary.

6. Provides information regarding processes for retrospective reviews, requests for length of stay extensions, etc., as needed.

7. Maintains knowledge of current exceptions to medical necessity requirements for psychiatric admission.

8. Accurately and fully completes and maintains all required paper documentation and electronic data entry.

9. Participates in quality assurance process, including documentation review and peer consultation.

10. Completes all authorizations within 1 hour of receiving complete referral information.

11. Meets all timeline requirements and completes data entry and paper document dissemination for all authorizations within daily shift.

12. Contributes to a phone room atmosphere that is consistent with delivery of compassionate, respectful and professional services.

13. Attends workshops and seminars as approved in order to meet WAC standards, and keeps updated on current professional literature and trends in mental health field.

AGENCY LEADERSHIP AND PROJECT SUPPORT 20%

1. Provides leadership and/or assistance with startup, time-limited and ongoing projects in support of agency goals and objectives.

2. Engages in interdepartmental collaboration.

3. Assumes various roles in support of projects, initiatives and programs outside of the HA department.

4. Leads and participates in the design and provision of training.

5. Acts as Crisis Clinic representative and spokesperson as assigned.

QUANTITY AND QUALITY OF WORK/WORK HABITS 10%

1. Arrives at work on time and maintains regular attendance; working assigned shifts and other shifts when needed.

2. Follows personnel policies and procedures.

3. Written and verbal communication is clear, concise, accurate and thorough.

4. Demonstrates genuine relationships by cooperating with others, handling disagreements directly with the person(s) concerned in a truthful and open manner, and accepting constructive feedback. Shows respect to co-workers, volunteers and customers/clients.

5. Makes appropriate use of supervisor.

6. Promotes a healthy work environment by demonstrating collaborative decision-making and team-building behaviors; provides peer support, and motivates staff and volunteers to outstanding performance.