Program Operator - BHUC at Southeastern Integrated Care LLC

Lumberton, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Jun, 26

Salary

0.0

Posted On

05 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Triage, Crisis Assessment, Intervention, Disposition Planning, Utilization Review, Insurance Verification, Data Collection, Process Design, Performance Tracking, Case Management, De-escalation, Psychoeducation, Relapse Prevention, Compliance Monitoring, Documentation, Training

Industry

Mental Health Care

Description

Summary: The Behavioral Health Urgent Care Program Operator is a key team member providing comprehensive oversight of programs to include organizing, coordinating, and monitoring all operations of the Behavioral Health Urgent Care (BHUC) team. This role operates at the Qualified Professional (QP) level, supporting triage, crisis assessments, interventions, and disposition planning for individuals experiencing MH/SUD/I/DD crises, while ensuring compliance with service definitions and promoting recovery-oriented care. The position supports the mission and vision of Southeastern Integrated Care (SEIC). Essential Duties and Responsibilities: * Supports the service line functions of the program to include intakes, utilization reviews, authorizations/verification of insurance, referrals, and team schedules. * Assists in the maintenance and/or modification of client data collection in the agency EHR system to ensure information remains as up to date as possible. This includes but is not limited to patient demographics (phone number, emergency contact, mailing address, employment information, etc.) * Determines team caseload by the level of acuity and the needs of the individual served. * Monitors and evaluates the services, interventions, and activities provided by the team. * Designs, organizes, establishes, and evaluates work processes to ensure delivery of program services and to fulfill program objectives. Studies existing policies, procedures, and directives and recommends revisions or additions when necessary. * Facilitating weekly admin meetings with BHUC team members. * Assist with completion of required documents to ensure compliance with service definition requirements. * Track team performance and beneficiary outcome data, and report to management as indicated. * Provides support to the team by receiving calls and responding to office walk-ins, triaging, and coordinating communication and engagement between the team, individuals, referral sources, MCOs/payors, etc. * Collaborates with internal team members regarding billing and authorization needs. * Assists with training needs of team members as directed by Supervisor or Training Coordinator. * Develops relapse prevention and disease management strategies to support recovery. * Provides psycho-education for the recipient, families, caregivers, and/or other individuals involved with the recipient about the recipient’s diagnosis, symptoms, and treatment. * Participates in the initial PCP and revision of the Person-Centered Plan (PCP) as needed. * Ensure and monitor the implementation of the PCP. * Spends time at the location where services are being performed as specified in the service definition for that service. * Participates in a first responder on-call system available to consumers and/or his/her natural support network on a 24/7/365 basis; coordinates “first response” resources according to consumer needs and the PCP. * Works closely with other clinical/professional staff to maintain communication and provide feedback, standardize procedures and expedite PCP implementation. * Ensures that all initial and reauthorizations for services occur in a timely fashion. * Provides timely and accurate information when requesting authorizations from the LME/MCO/Statewide Vendor and follows up on each request for authorization modified, not approved, and/or not responded to. * Facilitates relationships and serves as a link between the company, consumer, guardians, local agencies, and the community. * Practices standard medical precautions by understanding and utilizing personal protective and safety equipment. * Ensures confidentiality regarding sensitive and protected information. * Ensures individual rights to privacy and protected health information for the person supported. * Maintains records and charts each individual and reporting unusual and critical incidents in a professional, timely manner (within 24 hours). * Represent the company in a positive manner, reflective of the company’s mission, at all times. * Ensures service, agency, LME/MCO, state and/or federal documentation requirements and timelines such as NCTOPPs, PCPs/ITRs, and reminders relative to Clinical Monthly Summaries, Discharge Summaries, and Aggregate Reports. * Completes Intake Packets for any of the referrals that the office receives. * Accurately documents all billable encounters into Southeastern Integrated Care’s EMR (electronic medical record) system within 24 hours. Any corrections will be entered within 24 hours of being notified. * Reviews program operations for compliance, identifies program strengths and weaknesses and problem areas of non-compliance, recommends corrective action, and instructs individuals and groups on proper methods and procedures for compliance with program regulations. * Assists with planning, monitoring, and evaluating the program area. * Coordinates training and on-the-job shadowing activities for new hires. * Assists in triage within 15 minutes of arrival, determining urgency (routines referrals out; urgent/emergent eligible) and gathering releases for supports/providers. * Participates in crisis/risk assessments within 2 hours, addressing presenting problems, risks, biopsychosocial info, mental status exams, and level of care (e.g., ASAM). * Coordinates activities within the PCP, including interventions like de-escalation, psychoeducation, and modifiable risk factor planning. * Provides case management: links to services/referrals, schedules community resources, assists with housing/transportation/medication, and coordinates discharge planning (e.g., aftercare instructions, follow-up calls within 5 days). * Supports IVC first evaluations, inclusion of family/natural supports (with consent), and observation status (Tier IV only, up to 23:59 hours). * Demonstrates population-specific knowledge (MH/DD/SAS) and trains staff on individual needs. * In addition, the employee must participate in all required training and education as mandated by the specific service line and clinical coverage policy. * Other duties as assigned. Supervisory Responsibilities: This position can oversee paraprofessionals, peer support staff, and other team members as needed. Qualifications: 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. Education/Experience * Bachelor’s degree in Human Services field with 2 years of full-time, post-bachelor's degree accumulated MH/DD/SAS experience with the population served, OR * Bachelor’s degree in a non-Human Services field with 4 years of full-time, post-bachelor's degree accumulated MH/DD/SAS experience with the population served, OR * Registered Nurse (RN) with 4 years of full-time accumulated MH/DD/SAS experience with the population served, OR * Master’s degree in Human Services field with 1 year of full-time, post-graduate accumulated MH/DD/SAS experience with the population served. Required Skills/Abilities * Must maintain strict confidentiality. * Must possess effective communication/documentation skills. * Ability to learn and use personal computers. Work with a computer is common and the ability to understand word processing and certain spreadsheet programs is important. * Successfully complete other training as may be required or amended by company policy. * Develop organizational and communication skills that foster TEAMWORK. * Requires flexibility in scheduling and availability to adequately meet the service needs of the consumer/family and other team members. * Must have reliable transportation and be willing to travel locally. * Must meet 10A NCAC 27G.0104 Certificates, Licenses, Registrations * Valid NC driver’s license including personal vehicle insurance coverage. * Maintain current license/certification if applicable Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The work is typically performed in a BHUC facility (24/7 operations) or office environment, with a moderate noise level and potential exposure to crises. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; talk and hear; and taste and smell. The employee frequently is required to reach with hands and arms and stoop, kneel, crouch, or crawl. The employee is occasionally required to sit and climb or balance. The employee must be able to lift and/or move up to 20 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Must be able to drive and operate a personal vehicle safely and adhere to all applicable state and traffic laws.

Responsibilities

This role involves comprehensive oversight of the Behavioral Health Urgent Care (BHUC) program, including organizing, coordinating, and monitoring all operations at a Qualified Professional level. Essential duties include supporting triage, crisis assessments, interventions, disposition planning, and ensuring compliance with service definitions while promoting recovery-oriented care.