Clinical Reviewer DMH PASRR Hybrid; Metro Boston

UMass Med School
US - Massachusetts - Shrewsbury
December 27, 2024

Clinical Reviewer DMH PASRR (Hybrid; Metro Boston)

Minimum Salary

US-MA-Shrewsbury

Job Location

18 hours ago(12/23/2024 11:16 AM)

Requisition Number

2024-47497
• of Openings

1

Posted Date

Day

Shift

Exempt

Overview

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.

Responsibilities

MAJOR RESPONSIBILITIES:

Conduct completed evaluations prior to individuals nursing facility admissions; completed evaluations on individuals residing in a nursing facility when there are significant changes that signify the need for an updated evaluation.
Complete evaluations on an individualized basis, but in accordance with the most current federal rules, regulations, and evaluative criteria.
Communicate all evaluation findings to applicants, residents and/or guardians in an understandable manner and language.
Communicate determinations that identity a need for specialized services to the facility, agency, or referrals source, within appropriate timelines and data transmission policies.
Contact providers, state agency offices, and applicants/participants to obtain information and records needed to conduct a comprehensive clinical review of the case and final determination
Review and document all relevant information into data system applications in accordance with program guidelines and regulations
Maintain individual records documenting all applicant/participant encounters and contacts; write clinical summaries
Prepare and respond to requests for statistics and resource/service data
Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long term care facilities and other programs/organizations involved in the provision of services.
Participate in public relations efforts, attending conferences and meetings as needed
Maintain positive working relationships with applicant/participants, and relevant informal supports, provider organizations, program consultants and state agencies
Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations
Participate in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
Comply with established departmental policies, procedures and objectives.
Comply with all health, safety and program regulations and requirements.
Perform other similar and related duties as required or as directed.

Qualifications

REQUIRED QUALIFICATIONS:

Master's degree in social work; mental health counseling; related health and human services field; or equivalent OR a registered nurse (RN).
5 years of work experience providing direct service or case management to adults with psychiatric disabilities inclusive of 1 year of experience in a medical or clinical setting with knowledge of medical terminology. (If a Registered Nurse, must have a minimum 9 years of collective relevant education and work experience as outlined above).
Demonstrated knowledge and experience with relevant social service/rehabilitation systems.
Knowledge of applicable state and federal regulations
Ability to travel statewide.
Proficient in the use of Microsoft Applications, including Word, Outlook and database

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 one of the following areas: Long-Term Care, Home Care, Rehab, and/or Disabilities.
Ability to understand and utilize resources for problem solving, in order to deal with problems involving multiple variables, effectively prioritizing and executing tasks in a high-pressure environment.

Read the full job description and apply online on the recuiter's web-site

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