Job Description

** General Summary**

Under general supervision, obtains detailed clinical and demographic information regarding referrals into various higher level of care psychiatric programs (inpatient, partial hospitalization, intensive outpatient program), reviews patient information with designated psychiatry attending physicians, and manages the logistic details and communications required to successfully complete transfers for psychiatry admission. Interfaces with callers seeking information about psychiatry services and processes, patients/families, internal and external clinical referral sources, third party payors, receiving unit staff/providers, psychiatry attending physician reviewers, Maryland Office of the Public Defender, Maryland Office of Administrative Hearings, and other stakeholders. Obtains and documents complex and highly specialized psychiatry pre-certification authorization from commercial third-party payors. May act as Hospital Presenter in Involuntary Admission (IVA) Hearings and Hospital Presenter or Rights Lay Advisor in Clinical Review Panels. Performs the duties of PARC Administrative Assistant in addition to PARC Referral Specialist duties when workload volume or priority requires.

1. ** Principal Responsibilities and Tasks**

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Coordinates psychiatry transfer center: Service line/unit-specific lists for referrals to inpatient psychiatry units on DTC and MTC. Must be maintained in Emergency Medical Treatment and Labor Act (EMTALA)-compliant manner.
2. Determining capacity for admissions to maximize patient flow and bed utilization
3. Reviewing cases for admission with assigned attending psychiatrist or provider.
4. Call Center: High Volume Incoming and Outgoing Calls to facilitate job tasks and PARC operations
5. Document management including sensitive Protected Health Information: incoming and outgoing
6. Registration functions in Epic to create and document inpatient, partial hospitalization, and intensive outpatient encounter entries
7. Inpatient initial insurance authorization
8. Partial Hospitalization Program (PHP)/Intensive Outpatient Program (IOP) referrals and initial authorization
9. Serve as Hospital Presenter (involuntary admission hearings or clinical review panels) or Rights Lay Advisor (clinical review panels) when designated by PARC Manager

Qualifications

** Education and Experience**

1. Bachelor’s degree in psychology, social work, nursing, or a related health and human services field is required. Associate’s degree: May substitute 2 years of directly related experience in psychiatry admissions for Bachelor’s degree. HS Diploma: May substitute 4 years of directly related experience in psychiatry admissions for Bachelor’s degree.
2. One-year experience in a hospital or psychiatric treatment setting is preferred.

** Knowledge, Skills and Abilities**

1. Strong critical-thinking and problem-solving skills required to manage referrals and patient flow: matching individual patient needs to the right bed at the right time in the context of overall service demand and availability of resources.
2. Effectively manage competing priorities with high reliability and attention to detail.
3. Interact and communicate effectively verbally and in writing with patients, potential patients, and healthcare professionals in stressful situations while maintaining calm, courteous, exemplary customer service.
4. Accurate documentation and stewardship of protected health information.
5. Familiarity with psychiatric illnesses including working knowledge of DSM/ICD diagnostic categories and disorders and psychotropic medications commonly used in treatment of psychiatric illnesses and substance use disorders.
6. General familiarity with levels of psychiatric care available at UMMS and in the community. Direct callers seeking psychiatry treatment to appropriate resources, including callers in crisis.
7. Learn and maintain working knowledge of legal and regulatory requirements of hospital-based health care, transfers between health care facilities, patient rights, legal guardianship, procedures for emergency petitions and emergency psychiatric evaluations, voluntary and involuntary psychiatry admissions, involuntary admission hearings, and clinical review panel/forced medication processes.
8. Learn and maintain working knowledge of insurance prior authorization processes, including third party payor rules and clinical criteria for inpatient, partial hospitalization, and intensive outpatient levels of care.
9. Proficient in the use of technology to support communication, review of records, and documentation. Requires daily use of telephone, fax, email, secure text messaging, internet navigation including third party online portals, Microsoft Office applications, and electronic medical records system (Epic).

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation

• Pay Range: $21.5-$30.12
• Other Compensation (if applicable):

Review the 2024-2025 UMMS Benefits Guide