As a recognized leader in behavioral health and wellness industry, we are inviting you to join our growing Clinical Referral Line team. This team is dedicated to superior service and clinical excellence and enjoys working part time daytime hours!
General Summary : The Commercial Clinical Referral Clinical Care Managers (CCMs) provide telephonic assessments, referrals, and benefit-related counseling. Working online in various clinical information systems, the CCM collects clinical data from the caller that is sufficient to make appropriate referrals, triage and EAP assessment and certification decisions. Every call is triaged based on acuity and the level of risk to self and/or others. The CCM collaborates with providers to determine adequate and essential levels of care and to facilitate transfers to appropriate facilities and providers. They evaluate clinical appropriateness of treatment using professional knowledge within VOI clinical criteria and worksite guidelines and they render certification decisions or seek supervisory consultations for non-certification decisions. CCMs also facilitate coordination of care with other care managers to assure continuity of care.
Essential Duties and Responsibilities :
1. Completes telephone assessments and referrals; gathers demographic and clinical information to connect patient with appropriate provider, including outpatient treatment as necessary; and for emergency, urgent, routine and EAP referrals.
2. Reviews for medical appropriateness of psychiatric/substance abuse cases. Utilizes professional knowledge to apply VOI and contract-specific criteria in rendeing certification decisions. Applies VOI policies and procedures consistently.
3. Coordinates with other Care Managers and CRL Clinical Leadership to assure that patient comprehensive treatment needs are met.
4. Provides consultation to workplace on issues related to troubled employees, substance abuse cases, management referral, regulatory referrals, onsite training and debriefing services.
5. Maintains individual productivity and performance standards, as well as the telephone service standards which are in effect at the time.
6. Maintains positive working relationships with internal and external co-workers and customers to ensure optimal efficiency of service.
7. Maintains confidentiality and ethical and professional standards at all times.
8. Ensures continuity of patient care through contact with providers.
9. Performs special projects and other duties as assigned.
Job Requirements :
Education : Minimum of a master's degree in mental health related discipline or a minimum of an associate's degree in nursing with related psychiatric nursing experience.
Licensures : Current licensure in a mental health related field (RN, Ph.D., LCSW/ ACSW, LPC etc.). Current licensure must be maintained in the state where employed. Additionally, some client contracts will also require current licensure in the state in which their membership or consumer base resides.
Relevant Work Experience : At least three (3) years of direct practice experience in psychiatric or substance abuse treatment . Experience in settings that include inpatient, partial, and/or outpatient care preferred. Experience as a CEAP or EAP internal/external consultant to a work site area is desired.
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