Program Evaluation and Benefits Specialist

Primary Job Functions

Clinical Responsibilities

• Responds promptly to requests to meet with patients for benefits assistance
• Provides prompt and accurate clinical documentation, ensuring completion of the benefits process including denials and appeals
• Demonstrates the ability to recognize the elements of a crisis state and knows how to deescalate or resolve the situation
• Effectively determines the level of response needed in crisis situations and refers to the appropriate clinician and level of care
• Transports patients to benefits appointments if necessary
• Collaborates with other members of AltaPointe programs to help with placement of patients in services when necessary
• collaborates with outside entities in a professional and polite manner to ensure benefits process is followed to completion
• Follows up with patients who are in the benefits process or who may need extra assistance.
• Travels to patients’ homes to provide follow up as needed
• Advocates on behalf of the patient to secure community resources
• Adheres to professional standards
• Effectively demonstrates the application of adult specific competencies
  
  
  

Clinical Record Keeping

• Documents in a timely fashion per AltaPointe policy
• Learns and utilizes Avatar electronic health record and insure navigation tools appropriately
• Documents in detail the steps taken in the benefits process and linkage to appropriate follow up sources.
• Documents all calls and services provided before the completion of the shift.
• Documents case disposition, case closings, follow-up and referrals
• Documents legibly
  
  
  

Courteous and respectful attitudes towards patients, law enforcement, emergency personnel, visitors and co-workers

• Treats patients with care, dignity and compassion
• Respects patient’s privacy and confidentiality
• Is pleasant and cooperative with others
• Assists patients as needed
• Personal values do not inhibit ability to relate and care for others
• Is sensitive to the patient’s needs, expectations and individual differences
• Is gentle and calm with patients, families, and other agencies
  
  
  

Program Evaluation, Administrative, and Other Related Duties as Assigned

• Enters BHCC and grant-related data into database daily so as not to fall behind, catches up promptly if off work
• Maintains data in a confidential manner, does not share data with unauthorized persons or entities
• Understands current data software and learns new software and tools as needed, seeks to contribute to continuous quality improvement
• actively seeks ways to improve data collection, entry, and analysis
• Actively participates in Performance Improvement activities
• Completes assigned tasks in a timely manner
• Accesses appropriate community resources according to patient needs
• Follows AltaPointe policies and procedures
• Maintains current certifications and requirements for renewals, if applicable, and attends to required in-services and workshops
• Participates in ongoing staff education trainings
• Remains flexible, understanding that grant, DMH, and other data-related deadlines may alter scheduled daily activities
  
  
  

High School diploma. Knowledge of psychiatric and substance use disorders in the adult population and/or knowledge of addiction as a primary/secondary illness

• Knowledge of cultural diversity
• Knowledge of behavior management, crisis intervention and interventions common to acute psychotic patients, and/or patients with substance abuse issues as well as, to non-violent crisis intervention practice
• Knowledge of Psychiatric Rehabilitation principles and Substance abuse treatment principles
• Knowledge of available community resources
• Knowledge of Intellectual and Developmental Disabilities
• Knowledge navigating benefits and insurance providers
• Ability to obtain SOAR certification within one month
• Knowledge of billing and entry level accounting
• Knowledge of data collection methods, excel spreadsheets, analytic software
• Knowledge of rules and regulations regarding appropriate benefit entitlements such as social security, Medicaid, and Medicare