Clinical Coordinator – PASRR
- Employer
- University of Massachusetts Medical School
- Location
- 1 Technology Dr
View more categoriesView less categories
- Employment Type
- Full Time
- Institution Type
- Four-Year Institution
Job Details
Job Summary
Under the general direction of the Associate Director, or designee, the Clinical Coordinator (Team Lead) is responsible to develop, prioritize, and oversee staff activities that support Pre-Admission Screening Resident Reviews (PASRR) for individuals seeking nursing facility admission. This position ensures that Clinical Reviewers complete assessments based on state and federal regulations for individuals suspected/confirmed to meet criteria for serious mental illness (SMI), need for nursing facility services and appropriateness of placement in a nursing facility, as well as the need for specialized services or additional behavioral health services. This position provides leadership for the ongoing development of clinical competence and practice. In collaboration with colleagues, this position will supervise and implement improvements to clinical review activities.
Responsibilities
Major Responsibilities
- Provide clinical direction, supervision, and support to the clinical reviewer team performing evaluations of individuals applying to nursing facilities.
- Supervise the evaluation and assessment of eligibility requirements, including PASRR Level II evaluations, consistent with established procedural standards, program rules and regulations to monitor provider compliance.
- Review and complete categorical determination requests within specified timeframes.
- Assist in Clinical Reviewer case assignment, review and finalization processes.
- Participate in on-site visits to nursing facilities and community based-locations, as necessary.
- Collaborate with other applicable State Agencies regarding identified issues of various populations.
- Research regulations and interpret these regulations for providers, agencies and staff.
- Provide clinical support to program managers, and design and present training sessions for in-house staff or community-based providers as necessary.
- Review and propose changes to applicable program regulations, policies, and other documents.
- Coordinate contacts with providers to respond to inquiries pertaining to specific program areas, including acute care facilities and nursing facilities for pre-admission screening and resident review.
- Oversee data integrity measures by reviewing and documenting all relevant information into data system applications in accordance with program guidelines and regulations.
- Conduct routine and ad-hoc evaluations and re-evaluations of applicant’s/individual’s services.
- Support staff in contacting providers, state agency offices, and applicants/individuals to obtain information and records needed to conduct a comprehensive clinical review of the case and final determination.
- Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long term care facilities and other programs/organizations involved in the provision of services.
- Participate in public relations efforts, attending conferences and meetings as needed.
- Maintain positive working relationships with applicant/participants, and relevant informal supports, provider organizations, program consultants and state agencies.
- Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations.
- Foster team environment, and provide professional and clinical leadership to team members, including consultants, providers and administrative support staff as appropriate.
- Direct team members in identifying and addressing issues involving clinical matters.
- Interface with contractors regarding clinical determination of medical necessity and program compliance.
- Communicate policy, workflow and organizational changes to team members.
- Provide orientation and ongoing in-service/continuing education programs for team members.
- Conduct performance evaluations of team members.
- Participate in the hiring and termination of team members.
- Work closely with Associate Director and other management staff to ensure clinical integrity is maintained in the PASRR process
- In collaboration with the Director and other management staff, coordinate performance improvement and quality assurance activities.
- Prepare written reports/determinations as requested.
- Travel to and from providers’ places of business and state agency offices.
- Perform other related duties as required or directed.
Qualifications
Required Qualifications
- Bachelor's Degree in social work, mental health counseling, RN or a related health and human services field.
- 5-10 years of work experience providing direct service or case management to adults with mental health and behavioral health inclusive of 1 year of experience in a medical or clinical setting with knowledge of medical terminology.
- At least 2 years of recent supervisory or management experience in a clinical setting.
- Demonstrated knowledge and experience with relevant social service/rehabilitation systems.
- Knowledge of applicable state and federal regulations
- Ability to travel statewide.
- Proficient in the use of Microsoft Applications, including Word, Outlook and database.
- Ability to work weekends as on-call supervisor.
Preferred Qualifications
- Master's Degree in social work, mental health counseling, RN or a related health and human services field.
- Licensed Social Worker, Licensed Mental Health Counselor, Certified Rehabilitation Counselor, Registered Nurse or other licensed professional in a related field.
- Experience with mental health and behavioral health and/or long term care populations
- Experience in one of the following areas: community mental health services, Long-Term Care, Home Care, skilled nursing and rehab
- Ability to understand and utilize resources for problem solving, in order to deal with problems involving multiple variables, effectively prioritizing and executing tasks in a high-pressure environment
Additional Information
Supervision
Supervision Received
Supervision received from Associate Director
Supervision Exercised
Team Lead
Environmental Working Conditions
Remote/desk work with- some statewide travel may be required
Organization
Realize Your Opportunities – A Career at UMASS Medical School
Inside Workings at UMASS Medical School
The University of Massachusetts Medical School (UMMS), the Commonwealth's only public medical school, is proud of our role in serving the people of Massachusetts. Although, its the inside workings of UMMS that makes the difference.
Mission and Culture
- We’re serious about our mission and about our people.
- Real World Impact - Our people get excited about our mission of real-world impact in health sciences education, research and public service.
- International Prominence and New Opportunities - As this institution has grown to national – and international – prominence, we’ve found new opportunities to train tomorrow’s physicians, nurses and scientists, discover causes of and cures for disease and help improve the quality of health care.
- Deep Commitment - With our clinical partner, UMass Memorial Health Care, and our other teaching affiliates, we share a deep commitment to national distinction in patient care.
- Valued Partnerships – UMMS partners with Commonwealth Medicine, the health care consulting arm of UMMS. Also, UMMS partners with MassBiologics in scientific collaborations, technology management and creating partnerships for the development of products for the benefit of patients. These valued partnerships help us to provide services and programs to help meet our needs at UMMS and the public.
- Proud Contributors - People at UMMS enjoy the feeling of going to work every day knowing what they do is truly important and worthwhile.
- Complementary and Inseparable - These varied parts of our mission and culture are complementary and inseparable.
Careers
UMMS, the state’s first and only public academic health sciences center, educates physicians, scientists and advanced practice nurses to heal, discover, teach and care, with compassion. UMMS is a world-class institution with opportunities to match. 
Competitive Compensation – UMMS offers salaries that are competitive with Worcester-area employers. When combined with our generous benefits, perks, and paid time off, many job seekers are surprised to find a total rewards package that matches or exceeds their current situation.
Targeted Hiring Process – At UMMS, there are actually multiple hiring processes for different segments of our workforce. In nearly all cases, UMMS hiring process is decentralized, with qualified candidates screened and referred to an academic officer or manager with hiring authority.
24/7 Access to Employment Opportunities – iCIMS is our online job search and application system. iCIMS is available 24/7 to provide you with a convenient and up-to-date view of the available employment opportunities across our campuses. Updates are made daily and include all faculty and non-faculty position listings from every school and department within the UMMS. When you identify a position you are interested in and qualified for, apply online. New opportunities become available frequently so it pays to check back often!
Benefits
With outstanding benefits, competitive pay, extensive learning opportunities, and a stimulating and attractive work environment, UMMS may be exactly the employer you’ve been looking for.
• Superior Benefits - UMMS offers a wide range of benefits and perks that invite comparison with the best employers in the Worcester area – and with academic institutions anywhere. UMMS provides superior medical and dental coverage for you and your family, fully funded retirement plans, generous time off, a Tuition Assistance Plan – and much more.
• People Centered - UMMS is an employer, but it is also a community. Its comprehensive medical and dental benefits, retirement plans, and even paid holidays reflect an institution built around people, with a deep respect for their differences and needs.
• Commitment to Healthy Living - UMMS provides resources to help you balance work and life and encourages healthy living through great programs and discounts for fitness, physical activity, weight management, nutritional counseling and general wellness available through our health insurance plans.
• Breadth of Offerings - Above all, the breadth of UMMS offerings set the School apart and makes it an environment favored by all sorts of smart, career-savvy people.
Apply for a Job
As an equal opportunity and affirmative action employer, UMMS recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds.
Online - To view all job opportunities and apply online, visit www.umassmed.edu/hr and click on the “Careers” tab.
Start Now and Realize Your Opportunities!
A History of Making Vital Improvements - UMASS Medical School Milestones
1962: Legislation establishes University of Massachusetts Medical School
1970: First medical students begin classes in Shaw Building
1974: First class graduates 16 MDs
1979: PhD program begins
1986: Graduate School of Nursing opens
1986: PhD program becomes Graduate School of Biomedical Sciences
1994: Graduate School of Nursing initiates PhD program
1998: UMass Clinical System and Memorial Health Care merge to form UMass Memorial Health Care
2001: Lazare Research Building opens
2002: Campus Modernization begins on the University Campus
2004: Graduate Entry Pathway Program established at the Graduate School of Nursing
2005: PhD Program in Clinical & Population Health Research established at the Graduate School of Biomedical Sciences
2005: Massachusetts Biologic Laboratories opens new manufacturing and filling facility in Mattapan
2006: Craig Mello, PhD, Blais University Chair in Molecular Medicine and Howard Hughes Medical Institute Investigator, is awarded the Medical School's first Nobel Prize. Dr. Mello shared the 2006 Nobel Prize in Physiology or Medicine with Andrew Fire, PhD, of Stanford University, for their discoveries related to RNA interference.
2007: Michael F. Collins, MD, is named chancellor and Terence R. Flotte, MD, is named dean of the School of Medicine.
2009: Groundbreaking for the Albert Sherman Center, a 500,000-square-foot research and education facility slated for completion in 2012.
2010: Ambulatory Care Center opens
2012: The Albert Sherman Center, a 500,000-square-foot research and education facility, completed and opens
Get job alerts
Create a job alert and receive personalized job recommendations straight to your inbox.
Create alert