Referral Specialist - Primary Care - Bunnell

Top reasons to work for SMA Healthcare:

• Career growth and advancement potential
• Great benefits such as: Health, Dental, Vision, Life, & Disability Insurance
• Tuition Reimbursement
• Paid Personal Leave and Paid Holidays
• 403b Retirement Plan (matches one to one of employee contribution for the first 3%, then a 50% match on the next 6% of employee contribution)

Essential Job Functions:

• Completes calls from individuals inquiring about services, who are in need of immediate assistance, admitting to services, need information regarding services and community resources and linkage to SMA behavioral services.
• Requires the ability to perform independent analysis and problem solve.
• Provide back up to Access Center, inbound calls
• Responds to requests from hospital emergency department(s) to connect via telehealth with clients and provide information and education about recovery and Medication Assisted Treatment
• Provides information on Baker Act and Marchman Act
• Serves as back up for the Mobile Response Team's in office triage and dispatch
• Provides solution focused supportive counseling and linkage to individuals that need immediate services
• Collect demographic and insurance data, register new clients for services, verify insurance eligibility and benefits.
• Conduct authorization reviews with insurance companies for clients admitted to services.
• Notify staff of insurance authorizations through email and/or phone calls notifying them of authorization and insurance company expectations for the next review.
• Improves professional knowledge and skill base relevant to utilization management by attending seminars, trainings, and conferences and by reading current literature.
• Participates in required SMA in-service trainings to maintain employment.
• As assigned, assists in the maintenance of SMA's compliance with treatment and documentation requirements of funding sources, performance improvement, and accreditation activities.
• When assigned or review requires it, coordinator is knowledgeable of up to date standards/criteria of ASAM PPC, Medicaid, a particular MCO, DCF, and CARF.
• Makes commitment to SMA's mission and core values the SMA Way
• Abides by principles of EEO compliance and a workplace of dignity and respect.
• Works cooperatively in a group/team setting.
• Shows respect to others.
• Takes guidance and direction from supervisors.
• Arrives/Reports to work on time and ready to work.

Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Education and/or Experience: At minimum a High school Diploma and 4 years of direct care experience working in the Human services or related field. Graduation from an accredited school with a Bachelor degree in Human Services or a related field or a Master's Degree or Certified Addictions Professional (CAP) is preferred and can substitute for up to 2 years of work experience. Experience with American Society of Addictions Medicine Patient Placement Criteria is preferred. Experience with CARF, Medicaid, and Managed Care requirements is preferred.

Knowledge/Skills/and Abilities:

• Proficiency in working with telephone system and telephone etiquette.
• Must be knowledgeable and demonstrate competency in current best practices of behavioral health treatment and related services, especially as it relates to documenting the course of treatment and patient placement criteria in the client record.
• Depending on assignment must have knowledge of typical diagnoses, treatment services, and developmental issues for adolescents in general, delinquent adolescents, adults and pregnant/post-partum women who are admitted to a mental health and/or substance abuse treatment setting.
• Demonstrates proficiency with assigned client populations in performing utilization reviews in records of clients with specific problems and needs.
• Knowledge of the services provided at SMA at the various locations and able to correctly direct callers to the correct service.
• Proficiency in working with computer hardware and software, when assigned.

Necessary Special Requirements Possession of a valid Florida driver's license and acceptable driving record if required to drive SMA vehicle and/or use personal vehicle for SMA business. Proof of personal automobile insurance if the position requires you to drive your own vehicle for SMA business (does not include incidental use). Complete State of Florida mandatory level 2 background screening prior to start of employment if direct contact with children/adolescents, vulnerable adults, or the developmentally disabled may be involved. Complete Mandt, CPR, First Aid and HIV/AIDS training during the first six (6) months of employment and updated if required.

Physical: Mobility and ability to bend and reach during an 8-12 hour day. Able to lift minimum 10 pounds. Visual and auditory acuity sufficient to evaluate, intervene, treat, and record client health care needs. Fine motor skills for legible and accurate charting, daily correspondence and presentation, either manually or orally. Ability to speak clearly and audibly to communicate review finding to clinical staff and managed care reviewers, and to train staff in principles of UM. Work endurance ability to work 8-12 hour shifts with a meal break, as possible. Routine 8-12 hour shifts. Hours and days off may vary. Extra hours, including weekends and holidays, may be required. May require travel to other SMA locations. May require extended hours or overnight shifts during a natural disaster such as a hurricane. May require travel to other SMA locations.

Application: This class specification is intended to identify the class and illustrate the kinds of duties that may be assigned to its incumbents. It should not be interpreted as describing all of the duties whose performance may ever be required of such an employee or be used to limit the nature and extent of assignments such individuals may be given.