Explore the Possibilities
and Advance with Us.
Clinical Reviewer DMH PASRR - (Hybrid; South Shore/Boston)
Job Number : 2024-47056
Category:
Healthcare Location : Shrewsbury, MA Shift:
Day Exempt/Non-Exempt:
Exempt Business Unit:
ForHealth Consulting Department:
ForHealth Consulting - Community Service - W401950 Job Type:
Full-Time Salary Grade:
45 Num. Openings : 1 Post Date : Sept. 28, 2024 GENERAL SUMMARY OF POSITION: Under the general supervision of the Associate Director, or designee, the Clinical Reviewer II is responsible for completing Pre-Admission Screening Resident Reviews (PASSR) Level II Evaluations by conducting face-to-face evaluations and reviewing medical records, in accordance with relevant guidelines and regulations. This position ensures that individuals with mental illness (MI), seeking admission to or currently residing in a nursing facility, receive an in-person evaluation and nursing facility placement determination. MAJOR RESPONSIBILITIES: Conduct in-person evaluations to confirm the presence of MI and determine the appropriateness of nursing facility placement and the need for specialized services. Complete evaluations prior to nursing facility admissions and for individuals residing in a nursing facility when significant changes occur. Ensure evaluations are conducted on an individualized basis, following current federal rules, regulations, and evaluative criteria. Communicate evaluation findings to applicants, residents, and/or guardians in an understandable manner. Notify facilities and agencies of determinations requiring specialized services within appropriate timelines. Gather information and records from providers, state agencies, and applicants/participants for comprehensive clinical reviews. Document all relevant information in data systems according to program guidelines and regulations. Maintain individual records of applicant/participant encounters and write clinical summaries. Respond to requests for statistics and resource/service data. Promote continuity of care and partnerships with healthcare providers, hospitals, and other organizations. Participate in public relations efforts, attending conferences and meetings as needed. Maintain positive relationships with applicants/participants and relevant supports, providers, and agencies. Ensure confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations. Engage in performance improvement initiatives and apply quality improvement in daily operations. Comply with departmental policies, procedures, and objectives. Adhere to health, safety, and program regulations and requirements. Perform other related duties as required or directed. REQUIRED QUALIFICATIONS: Master's degree in social work, mental health counseling, a related health and human services field, or equivalent OR a registered nurse (RN). 5 years of experience providing direct service or case management to adults with psychiatric disabilities, including 1 year in a medical or clinical setting with knowledge of medical terminology. (If a Registered Nurse, must have a minimum of 9 years of collective relevant education and work experience). Demonstrated knowledge and experience with relevant social service/rehabilitation systems. Knowledge of applicable state and federal regulations. Ability to travel statewide. Proficient in Microsoft Applications, including Word, Outlook, and databases. PREFERRED QUALIFICATIONS: Massachusetts licensed Psychologist, Licensed Social Worker, Certified Rehabilitation Counselor, or other licensed professional. Experience with disabled or long-term care populations. Experience in community mental health services and in areas such as Long-Term Care, Home Care, Rehab, and/or Disabilities. Ability to understand and utilize resources for problem-solving in high-pressure environments.
#J-18808-Ljbffr
Healthcare Location : Shrewsbury, MA Shift:
Day Exempt/Non-Exempt:
Exempt Business Unit:
ForHealth Consulting Department:
ForHealth Consulting - Community Service - W401950 Job Type:
Full-Time Salary Grade:
45 Num. Openings : 1 Post Date : Sept. 28, 2024 GENERAL SUMMARY OF POSITION: Under the general supervision of the Associate Director, or designee, the Clinical Reviewer II is responsible for completing Pre-Admission Screening Resident Reviews (PASSR) Level II Evaluations by conducting face-to-face evaluations and reviewing medical records, in accordance with relevant guidelines and regulations. This position ensures that individuals with mental illness (MI), seeking admission to or currently residing in a nursing facility, receive an in-person evaluation and nursing facility placement determination. MAJOR RESPONSIBILITIES: Conduct in-person evaluations to confirm the presence of MI and determine the appropriateness of nursing facility placement and the need for specialized services. Complete evaluations prior to nursing facility admissions and for individuals residing in a nursing facility when significant changes occur. Ensure evaluations are conducted on an individualized basis, following current federal rules, regulations, and evaluative criteria. Communicate evaluation findings to applicants, residents, and/or guardians in an understandable manner. Notify facilities and agencies of determinations requiring specialized services within appropriate timelines. Gather information and records from providers, state agencies, and applicants/participants for comprehensive clinical reviews. Document all relevant information in data systems according to program guidelines and regulations. Maintain individual records of applicant/participant encounters and write clinical summaries. Respond to requests for statistics and resource/service data. Promote continuity of care and partnerships with healthcare providers, hospitals, and other organizations. Participate in public relations efforts, attending conferences and meetings as needed. Maintain positive relationships with applicants/participants and relevant supports, providers, and agencies. Ensure confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations. Engage in performance improvement initiatives and apply quality improvement in daily operations. Comply with departmental policies, procedures, and objectives. Adhere to health, safety, and program regulations and requirements. Perform other related duties as required or directed. REQUIRED QUALIFICATIONS: Master's degree in social work, mental health counseling, a related health and human services field, or equivalent OR a registered nurse (RN). 5 years of experience providing direct service or case management to adults with psychiatric disabilities, including 1 year in a medical or clinical setting with knowledge of medical terminology. (If a Registered Nurse, must have a minimum of 9 years of collective relevant education and work experience). Demonstrated knowledge and experience with relevant social service/rehabilitation systems. Knowledge of applicable state and federal regulations. Ability to travel statewide. Proficient in Microsoft Applications, including Word, Outlook, and databases. PREFERRED QUALIFICATIONS: Massachusetts licensed Psychologist, Licensed Social Worker, Certified Rehabilitation Counselor, or other licensed professional. Experience with disabled or long-term care populations. Experience in community mental health services and in areas such as Long-Term Care, Home Care, Rehab, and/or Disabilities. Ability to understand and utilize resources for problem-solving in high-pressure environments.
#J-18808-Ljbffr
