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Clinical Utilization Specialist

Location
Salina, KS

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u003ctable width=u00220u0022u003enu003ctbodyu003enu003ctru003enu003ctdu003enu003cpu003eu0026Oslash;u0026nbsp; Reviews placement to ensure the child is in the most appropriate/least restrictive level of care based on MH needs.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Reviews and authorizes all requests for attaining highest level of care (acute/SHA/PRTF) for children/ youth in our careu003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Requests, participates and facilitates all PRTF authorizations for admission, treatment reviews, discharge meetings, and appeals.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Appropriately documents all reviews and assures entry of all pre-certifications /authorizations into the management information system (MIS).u0026nbsp; Notifies all providers that services have been approved.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Schedules and facilitates requested placement stability staffingu0026rsquo;s involving all parties involved in the care of the child (foster parent, case management team etc.)u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Liaisons with Medicaid entity (MCO) for admission to Medicaid reimbursed treatment facilities.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Liaisons with Community Mental Health Centers, Private Mental Health Providers, Community Developmental Disability Organizations, other community services providers and SFCS staff.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Liaisons with PRTFu0026rsquo;s and Acute Hospitals.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Determines appropriate PRTF setting for admission based on individual needs.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Works as a team and participates in placement process for children and youth leaving the highest level of MH care.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Works collaboratively with Care Center placement staff regarding placements of children and youth that require higher levels of service/care.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Ensures quality services are in place for children and families.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Utilizes trauma systems therapy model of care.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Provides consultation and trainings as needed.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Participates in Mental Health on-call rotation.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Implements SFCS policies and follows directives as required. Follows and adheres to all pertinent SFCS Standard Operating Procedures (SOPu0026rsquo;s), rules, personnel policies and procedures; related accreditation and licensure standards; and federal, state and local rules, statutes, regulations, and contractual termsu003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Reports unusual incidents through appropriate Risk Management, clinical and safety channels.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Ensures clientsu0026rsquo; rights are protected.u003c/pu003enu003cpu003eu0026Oslash;u0026nbsp; Is knowledgeable of and follows all safety procedures.u003c/pu003enu003c/tdu003enu003c/tru003enu003c/tbodyu003enu003c/tableu003e

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