PartnersACCESS Specialist QP (PRN; Remote Option)

Office Location: Available for any of Partners' locations; Remote option available Work Schedule: PRN with Monday-Friday 8a-5p availability Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: This position provides the initial screening, referral and or scheduling of members who call the toll-free PartnersACCESS Member Services number seeking health and behavioral health services and as appropriate, transfers the member to a clinician who will clinically triage/assess the member’s acuity and will determine what type and intensity of service the member needs and/or is eligible to receive.

Screening, scheduling and referral: Initial screening of Health/Mental Health (MH)/Substance Use (SU)/Traumatic Brain Injury (TBI)/Intellectual/Developmental Disability (I/DD) treatment needs, benefit information and referral of members calling to determine if they may potentially qualify for services Collect and enter demographic data into the electronic record, completion of appropriate forms, explanation of services, benefits and resources, verifies Medicaid and dispatch Provide follow up calls to referral sources and members to ensure that members have been successfully engaged in services Make referrals to clinical homes and crisis providers that meet the timeliness standards as defined by NC Medicaid Provide information about local community resources, independent practitioners, and related providers for referrals for basic benefit services This position demands a high level of accuracy and confidentiality. Information must be handled according to NC standards and rules, state and federal laws and LME/MCO and NCQA standards, procedures, policies and protocol Authorizations: Assists with authorizations/admissions to state hospitals, ADATC, Three Way Hospitals, Level III Detox, Facility Based Crisis and all referrals to crisis services Process other acute care authorizations as requested by supervisor or other Access to Care Licensed Clinician Automation: Screenings are completed using standard and specialized computer programs Inputs accurate information into the system and unlocks electronic service records with appropriate consents, enters all necessary data elements into data systems Provide technical assistance to First Responders, clinical home providers, and Mobile Crisis Management Cooperative Efforts: Establish and maintain effective working relationships within the unit, agency, and service system Consistently demonstrate professionalism, tact and diplomacy in handling irate callers and/or working with contract providers and other external parties Participate in Unit Staff meeting, Agency Staff meetings, (All staff meetings) and assigned committees