Transitions Health Mgmt Intake and Emergency Dept Coord (QP)-NC at Partners Behavioral Health Management

Gastonia, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

04 Feb, 26

Salary

0.0

Posted On

06 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Knowledge of MHSU/IDD Service Array, Communication Skills, Problem Solving Skills, Negotiation Skills, Conflict Resolution Skills, Detail-Oriented, Organizational Skills, Decision Making Skills, Documentation Skills, Compliance Knowledge, Interpersonal Skills, Computer Skills, Care Management, Medication Management, Outreach Skills, Team Collaboration, Crisis Management

Industry

Hospitals and Health Care

Description

Competitive Compensation & Benefits Package! Position eligible for – * Annual incentive bonus plan * Medical, dental, and vision insurance with low deductible/low cost health plan * Generous vacation and sick time accrual * 12 paid holidays * State Retirement (pension plan) * 401(k) Plan with employer match * Company paid life and disability insurance * Wellness Programs * Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Available for any of Partners' NC locations; Remote option in NC Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Transitions Health Management Intake and Emergency Department Coordinator performs intermediate administrative work as well as other qualified professional duties related to overseeing the coordination and management of care for members. The role is responsible for providing outreach, screening and treatment coordination. The support provided is telephonic, two-way audio-visual and occasional onsite emergency department visits along with facilitation of and referral to community-based teams when necessary. The purpose of this position is to ensure that members receive coordination and continuity of care as they transition between different settings or levels of care focusing on intake, emergency department discharge needs and follow up care This position will also assist members in their efforts to improve their quality of life across the Physical Health, Behavioral Health, Intellectual/developmental Disability (IDD), Traumatic Brain Injury (TBI), and Pharmacy domains to help prevent hospital readmission. The Transitions Health Management Intake and Emergency Department Coordinator works with the Transitions Health Management team, the member, Tailored Care Manager, and community-based care team to identify and alleviate inappropriate levels of care or gaps in services. Travel is a function of this position. Role and Responsibilities: The Transitions Health Management Intake and Emergency Department Coordinator is responsible for (though not limited to): * Support members transitioning from Emergency Department settings to the appropriate lower or lateral level of care * Provide subject matter expertise, within scope, regarding member’s physical and/or behavioral health to support the development and delivery of a whole person approach to Care Management  * Collaboratively works with other Partners team members, behavioral health providers, primary care physicians, specialty care providers and other community partners and stakeholders to support members in their home communities * Conducts on site visit with member during their stay in emergency department as necessary * Conduct outreach to the member’s providers. * Obtain a copy of the discharge plan and review the discharge plan with the member, facility staff and Tailored Care Manager. * Facilitate clinical handoffs. * Assist the member in obtaining needed medications prior to discharge, ensure an appropriate care team member conducts medication reconciliation/management and support medication adherence. * Communicate and provide education to the member and the member’s caregivers and providers to promote understanding of the ninety (90) day post-discharge transition plan, hospital discharge plan * Assist with scheduling of transportation, in-home services, and follow-up outpatient visits with appropriate providers within a maximum of seven (7) Calendar Days post-discharge, unless required within a shorter timeframe. * Ensures the member understands and can access the Partners self-management tools and digital applications * Ensures follows up with the member within forty-eight (48) hours of discharge. * Appropriately escalate high risk/high visibility and/or complex barriers/needs members who may have difficulty transitioning out of the facility in a timely manner to supervisors. High risk can involve Health and Safety of a member, staff, or organizational risk  * Review cases with clinical complexity with direct supervisor and follow escalation protocols to ensure timely engagement from members or our Medical Team and Provider Networks  * Obtain information releases that will improve care management activities on behalf of the member * Manage the CTT_InpatientED_Referrals inbox and process all incoming referrals from ADT feeds, UM notifications, census reports, NC HealthConnex, and hospital/facility liaisons. * Screen referrals for program eligibility (Medicaid/Tailored Plan status, qualifying transition setting, etc.). * Assign cases daily to Care Transitions Care Managers based on acuity, facility location, and team workload. * Enter referral and intake data accurately in TruCare within established timeframes (24 hours of receipt). * Conduct intake calls with hospital staff, members, or caregivers to explain the Care Transitions process, obtain consent, and gather baseline data. Knowledge, Skills and Abilities: * Considerable knowledge of the MHSU/IDD service array provided through the network of the LME/MCO’s providers * Knowledge of LME/MCO’s implementation of the 1915(b/c) waivers and accreditation * Highly skilled at assuring that both long and short-range goals and needs of the individual are addressed and updated, while assuring through monitoring activities that service implementation occurs appropriately * Exceptional interpersonal and communication skills * Excellent computer skills including proficiency in Microsoft Office products (Word, Excel, Outlook, and PowerPoint) * Excellent problem solving, negotiation, arbitration, and conflict resolution skills * Detail-oriented, able to organize multiple tasks and priorities and effectively manage projects from start to finish * Ability to make prompt independent decisions based upon relevant facts, to establish rapport and maintain effective working relationships * Ability to change the focus of his/her activities to meet changing priorities * A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance * Documentation and Compliance * Maintain complete and accurate records of all referrals, intake actions, assignments, and follow-up documentation in TruCare. * Ensure compliance with the NC TCM Provider Manual standards for contact timeliness, reassessment, and documentation. * Participate in internal audits, performance reviews, and process improvement initiatives. * Adhere to HIPAA and Partners Health Management data privacy and security policies. Education/Experience Required: Qualified Professional Care Manager (Non-Licensed):  * Bachelor's degree in a human service field with two years of full-time, post-bachelor's degree experience with the population served  -or-  * Bachelor's degree in a field other than human services with four years of full-time, post-bachelor's degree experience with the population served  -or-  * Master’s degree in a human service field and one year of full-time, post-graduate degree experience with the population served  Other requirements: • Must reside in North Carolina. • Must have ability to travel as needed to perform the job duties **In this role, when visiting hospitals, staff may be asked to verify the status of vaccination or immunization or a statement of exemption (including but not limited to COVID) to meet the requirements of the hospital. Education/Experience Preferred: Experience working in a complex health whole person care space focused on transitions of care with individuals of all ages. Licensure/Certification Requirements: N/A

Responsibilities

The Transitions Health Management Intake and Emergency Department Coordinator oversees the coordination and management of care for members, ensuring they receive appropriate support during transitions between care settings. This includes outreach, screening, treatment coordination, and facilitating referrals to community-based teams.