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Utilization Review Coordinator



Location: Montgomery, Alabama
Department:
Posted: 01-23-2019
Location Name: MAMHA - Montgomery County
Wage Max: 51,831.00
Wage Min: 34,063.00
Position Type: Full time
Shift: 1st Shift

 JOB DESCRIPTION

 

TITLE:                         Utilization Review Coordinator

 

CLASSIFICATION:    Mental Health Specialist III

 

SALARY RANGE:       $34,063.00 - $51,831.00

 

SUPERVISOR:             Clinical Director

 

DEFINITION:

 

This is a responsible administrative and clinical position calling for the organization and tracking of utilization review information for the mental health centers of Alabama designated as belonging to Service Area III.

 

DESCRIPTION OF DUTIES:

 

Responsible for developing a working knowledge of all community mental health center operated/contracted residential services in his/her service area relative to admission criteria.

 

Responsible for developing a working knowledge of state hospitals serving his/her service area related to discharge planning.

 

Responsible for making regular contacts (at least monthly) with facility staff involved in discharge planning at the state hospital.

 

Responsible for ensuring regular contacts with CMHC designees involved in accepting residential referrals.

 

Attend training related to the UR functions provided and/or coordinated by the DMH.

 

Assist with training DMH and CMHC staff regarding UR concepts and issues as requested by a mental health center, a state hospital, or central office personnel

 

Coordinate discharges into residential services across the catchment area when necessary or requested by a CMHC, a state hospital, or central office personnel.

 

Monitor lengths of stay in all residential programs with the exception of supported housing/apartments relative to the expected length of stay as contained in the certification standards and the program description and as compared to other programs in the same certification classification.

 

JOB DESCRIPTION (Continued)

Utilization Review COORDINATOR

Description of Duties:

 

 

Provide reports and data to the DMH and to the CMHCs relative to the monitoring function in the form and manner specified by DMH.

 

Assist DMH and centers in locating options for consumers who have special needs that cannot be met in their home areas.

 

Assist DMH in maintaining a complete and accurate database for all certified residential programs in the Mental Illness Vacancy Reporting system.

 

Provide input into the planning process as needed relative to types of residential services need and/or modifications needed to the existing services.

 

Conduct reviews on 30-day readmissions.

 

Assist in facilitating cross-catchment placements in order to best meet the individualized needs of the consumers. These placements may be discharges from a state facility or transfers from one residential program to another.

 

Help facilitate movement out of state facilities by assisting with difficult placements.

 

Conduct monthly meetings with CMHCs in region.

 

Responsible for the implementation of program objectives and operations plans.

 

Responsible for tracking UR data provided by Service Area III mental health centers.

 

Responsible for tracking UR indicators selected for monitoring the effectiveness of the UR efforts.

 

Prepares reports of UR activities as required and disseminates as approved.

 

Responsible for maintaining clinical records as appropriate to completing UR specialist activities for any given service consumer or group of consumers.

 

Attends all meetings of the UR Specialist as called by the Alabama Department of Mental Health and Mental Retardation or the Alabama Council of Community Mental Health Boards.

 

Responsible for the physical assets of the Authority assigned to the use of the UR Coordinator.

 

Conducts special projects/assignments as requested by the Executive Director.

JOB DESCRIPTION (Continued)

Utilization Review COORDINATOR

REQUIREMENTS:

 

Working knowledge of the principles of utilization review and quality improvement as applied in medical or mental health setting.

 

Knowledge and training in mental illness program operations, structure and development.

 

Knowledge of the theory and application of QI/PI principles.

 

Ability to apply programmatic knowledge to the operations of programs for the seriously mentally ill.

 

Ability to effectively communicate in writing and in person so that the UR specialist efforts of the entire Service Area are enhanced and maintained.

 

Demonstrable communication and interpersonal relationship skills.

 

Proven writing skills.

 

Ability to fluently use word processing, database and spreadsheet computer programs in a productive manner.

 

Reliable transportation.

 

QUALIFICATIONS:

 

Master’s degree from an accredited college or university in psychology, social work or related field. Must hold and maintain a driver’s license valid in Alabama. Must have and maintain a driving record that is acceptable to the Authority’s insurance carrier. Must maintain liability coverage on personal vehicles.

 

 

 

 

Revised:  August, 2016

                 9/26/2016