Member & Recipient Services Clinician (Mon-Fri, 11A-8P)

• Answer and provide disposition to service request calls at times of heavy call volume
• Perform clinical screening, triage and referral to consumers needing services.

• Handle crisis calls in the Member Services Call Center: Triage calls for urgency and facilitate access to crisis services when risk indicators are present. Where safety is at risk, the employee initiates immediate intervention via law enforcement, emergency medical assistance, or involuntary commitment.
• The employee provides brief crisis interventions and/or support when indicated to facilitate the assessment process, encourages compliance, addresses safety issues, etc. Clinical functions are performed by the Member Services Clinicians.
• The employee accurately documents all contacts according to LME and State standards and promptly transfers screening and triage information to the provider of choice to conduct the assessment and develop the Person-Centered Plan.

• Mental concentration is required in all aspects of work.
• Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
• Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
• Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.

KNOWLEDGE, SKILL & ABILITIES:

• Ability to collaborate with providers and other agencies.
• Mastery of utilization review principles to resume continuity of care and clinical evaluations as needed for appropriate provision of intensive, crisis services and other levels of care to ensure linkage to correct services.
• Comprehensive knowledge of resources and the ability to use a personal workstation.
• Knowledge of documentation and clinical protocols for utilization purposes.
• Clinical knowledge of mental health and substance abuse treatment as a basis for clinical triage and referral decisions
• Knowledge of linage, authorization and level of care determinations, assisting providers with creative problem solving to suggest alternative approaches to care.
• Clinical knowledge of managed systems of mental health and substance abuse. Knowledge of managed behavioral care practices.

Other skills or abilities require are as follows:

• The ability to express ideas clearly and concisely orally and in writing, and to plan and execute work effectively and efficiently.
• Familiarity with mental health, developmental disability and substance abuse disorders.
• Knowledge of the laws, regulations, and policies which govern human services and utilization management.
• The ability to interact professionally and effectively with persons who are upset and who disagree.
• The ability to work responsibility and effectively with others for a timely resolution of the caller’s needs.
• Knowledge of behavioral health principles, techniques, and practices, and their applications to complex treatment and service provision.
• The ability to remain professionally responsive in an ethical and sensitive manor to individual’s needs throughout the course of the work day/shift.
• Considerable knowledge of person-centered and recovery philosophies.