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Behavioral Health Resource Coordinator (LCSW or RN) - Care Logistics Center

Requisition ID:

21162096

Business Unit:

Hartford HealthCare Corp.

Location:

Newington, CT

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Description

Job Schedule: Full Time
Standard Hours: 36
Job Shift: Shift 1
Shift Details: M-F, hours may be negotiable

Work where every moment matters. 

Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. 

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Summary

The BH Resource Coordinator is responsible for facilitating patient transitions to inpatient behavioral health beds by verifying accurate insurance information ,securing insurance precertification(s) utilizing a strong understanding of criteria for inpatient care,  and when necessary doing bed searches to other facilities both within and outside the network to promote timely access to appropriate level of care.  This person utilizes strong interpersonal and communication skills to assist in bed management activities as needed, is highly knowledgeable of network entity capabilities and can navigate bed management for uncomplicated bed placement needs.

Responsibilities

  1. Acts as a resource with expertise in managed care, stays updated in current insurance practices and specific insurance nuances including network participation and keeps colleagues informed of same. Collaborates with patients/families as necessary to ensure understanding of complexities of insurance plans when it may have an additional financial impact on the patient.

  2. Arranges for SCA’s (single case agreements) when indicated; obtains temp. ID’s for uninsured if eligible.  Informs through Epic if all options are exhausted and patient will be self-pay.

  3. Understands any payer nuances among the HHC entities and acts as resource in this area.

  4. Responsible for all insurance authorization activities for patients in the HHC ED and Husky precertifications on all patients coming to HHC from all referral sources.  This includes preliminary insurance investigation, finding insurance cards, EDS Medicaid verification, communicating with patient accounts or family members to obtain accurate information.   Keeps record of authorizations to ensure that they are obtained on all admissions including follow up the following business day. Enters insurance authorization information obtained by other sources (consult liaison service, and outside referral facilities) who have completed the precert.   Ensures that criteria is met for inpatient level of care upon requesting authorization. Collaborates with Utilization Management teams on units when follow up is necessary. Documents all activities and authorization information in auth cert section of Epic.

  5. Acts as expert in Epic registrations, auth cert., etc and acts as resource for staff as needed to ensure that documentation of authorization details are accurate and complete;

  6. Also acts as expert and primary resource for Bed Management/ Transfer Center applications in Epic for behavioral health.  Maintains Protocol Books for each Entity and reviews /corrects errors in data entry as identified by auditors to ensure accurate productivity reports.  Provides corrective feedback to staff as needed in this area. 

  7. Acts as a trainer to new staff to the CLC Epic applications.   

  8. Conducts bed searches at the direction of the bed manager, searching HHC entities first, then expanding to other entities if necessary, considering locations closest to patients home or at patient request for specific facility.  Activities include sending faxed information to potential receiving facility(s) if not on Epic, multiple follow up calls to confirm receipt and for update of status in acceptance process, coordinating accepted patient transition by connecting nurse to nurse report and arranging transport.

  9. Collaborates with bed managers to determine bed placement priorities as set forth in Standard Work.

  10. Documents patient’s placed outside of network and reasons for same

  11. Conducts bed huddles with units when called upon to do so and attends hospital huddles as needed with updates on bed status for the BH patients in HHED.

  12. Maintains positive collaborative relationships with sending and receiving entities and professionals.

  13. Perform routine bed placement and registration activities when not busy with above activities.  ie. takes referral calls and enters pended requests, drops patient in beds, etc.  consults with RN before placing patient 

  14. Enters bed availability on the  Beacon Provider Connect website daily.

  15. Maintains H3W leadership behaviors and is accountable for all interactions

  16. Models customer service standards and demonstrates value for all people in the work       environment

  17. Informs all staff of updates in passwords on the state EDS website for insurance verification.  Maintains current IOL/HH contact information necessary to the CLC daily work.

Qualifications

Requirements

  • Masters Degree in Social Work or Bachelors Degree in Nursing
  • Current CT LCSW license or current CT RN license
  • Minimum  5+ years exp in behavioral health field.  Understanding of levels of care criteria, diagnostic nuances, and inpatient milieu concerns strongly preferred.  Ability to navigate managed care systems in obtaining accurate BH insurance information  

We take great care of careers.


With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

 
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