Psych Triage Coordinator,LMHC, LCSW or LICSW requiredfull-time eveningsJob ID 13502232
Description•Triages all incoming phone calls and pages
•Facilitates admissions to 2 South, Partial Programs, 6 North ARP and Evening Addiction
•Evaluates patients presenting in the ER for 6 North ARP admissions
•Verifies insurance for incoming patients
•Obtains initial insurance authorization for patients who are admitted to 2 South, 6 North and the Partial programs.
•Responsible for obtaining pre certification when required by payor.
•Cross train to provide coverage to the Utilization Manager and CL Social Worker.
•MBHP bed board updated each shift.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation.
Supervisory/Managerial Responsibilities (Y/N): N
Includes Budgetary Responsibilities (Y/N): N
•Receives all incoming phone calls from persons and providers requesting acute clinical services for psychiatry and addictions to determine appropriate level of care.
•Refers callers to appropriate location and insurance services for level of care assessments.
•Conducts preliminary assessments by gathering data from provider and/or through patient interview to obtain medical, addiction, psych, social and treatment histories, and pertinent collateral information from appropriate sources.
•Reviews clinical data and determines appropriate level of care for the patient after consulting with the attending physician.
•Completes an intake and submits triage/detox assessment via inbasket to the doc on call (DOC) followed by paging the DOC with patient name and MR number. Document patient’s clinical information and any other pertinent data needed by members on the interdisciplinary treatment team into Epic.
•Contacts managed care representatives, third party payers, primary physicians or other relevant persons in order to provide clinical and/or demographic information required to verify insurance and/or obtain authorization for clinical services.
•Records all pertinent insurance information on insurance tracking sheet in Epic.
•Arranges for admission and/or referral to the most appropriate level of care based on an assessment of the patient’s clinical needs.
•Communicates with the charge nurse if the patient is admitted to the in-patient unit.
•Refers patients, as clinically indicated, to external services when a service is not provided within the array of Brigham and Women’s Faulkner Hospital’s programs. In instances involving a capitated patient, the Triage Clinician consults with the medical director and/or designee to receive final authorization for the external referral.
•If a patient meets all requirements needed to be admitted to one of the partial programs Triage will contact the department patient access coordinators via inbasket to schedule the patient.
•Obtain pre certifications when required by insurance payors.
•Demonstrates effective communication “hand offs” between providers, shifts, departments, etc.
•Notify BWFH admitting when patient has been accepted.
•Establishes a working relationship with insurance and managed care utilization staff to process authorizations for clinical services effectively.
•Provides clinical triage services to the Emergency Department and other hospital departments where appropriate.
•Develops a working knowledge of the various payers admission criteria to ensure that the requirements for pre-certification are met.
•When appropriate, performs initial clinical evaluations to determine the acute mental health and/or substance abuse needs for patients in the Emergency Department and/or med/surg floors.
•Conducts bed searches with the BEST and FAST teams.
•Participates in data collecting for monthly statistics reports.
•Performs administrative tasks that include but are not limited to the following: utilization and management reports, monthly statistics and any other administrative task that is assigned by supervisor.
•Responsible for making sure MBHP bed board is updated during each shift.
Brigham and Women's Faulkner Hospital is a 171- bed non-profit, community teaching hospital located in Jamaica Plain directly across the street from the Arnold Arboretum. Founded in 1900, Brigham and Women's Faulkner Hospital has a long history of meeting the health care needs of our patients by offering comprehensive care in a wide variety of specialties. At Brigham and Women's Faulkner Hospital, our world revolves around our patients and their families, which is why we’ve been nationally recognized for our best practices in patient care, safety measures and surgical outcomes. If you’re looking for more than a career, join Brigham and Women’s Faulkner Hospital. Our patients call it better care. Our employees call it home.
•LMHC, LCSW or LICSW required to evaluate patients for Level of Care Assessments in the ER.
•De-escalation Training annually
•Required clinical coursework in psychiatry and addictions
•Preferred work experience in admissions
EEO StatementBrigham and Women’s Faulkner Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to an employee’s protected status, such as age, race, sex, color, ancestry, religion, national origin, physical or mental disability, veteran status, citizenship, gender identity or expression or sexual orientation.