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Clinician/PASRR Evaluator

Job Title
Clinician/PASRR Evaluator
Job ID
946352
Begin Date
4/30/15
Duration
Location
Oakland,  CA
Other Location
Description
APS Healthcare, a subsidiary of Universal American, is a healthcare company with over two decades of pioneering innovative collaborations between patients, doctors and our company that produce healthy outcomes for all. Universal American is a New York Stock Exchange company with annual revenues of more than $2 billion. Through our family of healthcare companies, we provide health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcare costs.

Well-capitalized and highly entrepreneurial, Universal American has been on the cutting edge of healthcare for more than 21 years. We offer Medicare Advantage plans to people with Medicare. We partner with providers in Accountable Care Organizations that serve people with Original Medicare. And we provide array of healthcare services to states, municipalities, health plans and other entities in the world of Medicaid. In everything we do, we focus on improving the coordination of healthcare through collaboration between payers, providers and patients to achieve the best health outcomes possible.
For more information on Universal American, please visit our website at www.UniversalAmerican.com.

APS is hiring for its new California statewide PASRR program, which is responsible for conducting level of care evaluations for individuals referred to nursing homes that have or may have a severe mental illness. The evaluator conducts a complete assessment based upon client interview, medical records review, and collateral contact to determine whether specialized services are necessary for the client’s mental health needs. As a Clinician / PASRR Evaluator you will be responsible for completion of clinical evaluations of individuals referred by acute care or nursing facilities for a Level 2 pre-admission screening or resident review. These are individuals with a suspected or confirmed mental illness and who are seeking admission to a Medicaid certified nursing facility, or who are currently residing in a nursing facility whose physical and/or mental functioning has significantly changed. The Clinician / PASRR Evaluator communicates with service providers, reviews available medical records, consults with family or other collateral sources, and interviews the patient. The PASRR Evaluator uses the State of California’s web based application to conduct an assessment and provide recommendations for a plan of care. The Clinician / PASRR Evaluator travels to various facilities and is reimbursed for mileage.

Clinician / PASRR Evaluator  Summary of Responsibilities:
  • Ensures accurate PASRR evaluations through accurate clinical assessment of the patient, relevant records, and collateral sources of individuals with suspected or confirmed mental illness to determine the presence of a Serious Mental Illness (SMI), as defined by 42 CFR 483.102(b)(1). Ensures accurate PASRR review completion by determining appropriate level of care based on the patient’s physical, behavioral, and psychological functioning.
  • Ensures compliance with necessary workflow include re-review of records based upon input from QA Director and/or Medical Director.
  • Respond to inquiries California State Consulting Psychologists regarding evaluations conducted.
  • Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
  • Review current literature, regulations, and research related to long term care, mental illness, medical conditions, and geriatrics.

Clinician / PASRR Evaluator  Education:
  • LCSW, LPCC, MFT, Licensed Clinical Psychologist, Nurse Practitioner, or other qualified Licensed Mental Health Professional approved by State of California Department of Healthcare Services.
Clinician / PASRR Evaluator  Required Experience:
  • Minimum of 2-years’ experience in the assessment, diagnosis, and treatment planning of individuals with mental / psychiatric disorders, including complex differential diagnoses that are related to substance use, medical conditions, cognitive issues, and dementia.
  • At least 2 of the last 5 years must include service provision to mentally ill clients.
  • Experience with geriatric population is preferred.
  • Knowledge of Federal Regulation 42 CFR, Chapter 483
  • Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in California.
  • Knowledge of standards of practice related to determination of Level of Care.
  • Knowledge of standards of practice related to mental health, geriatric, and other disorders typically requiring long term care placement
  • Knowledge and understanding of public sector services and supports.
  • Computer proficiency in Microsoft Excel, Word, and Outlook.
  • Ability to determine a clinical diagnosis and develop an individualized Plans of Care to address psychological and behavioral issues.
  • Ability to utilize computer equipment and web based software to conduct work.
  • Ability to interact with various office staff as needed to support necessary workflows.
  • Ability to interact with healthcare professionals, patients, their families, and other supports.
  • Ability to provide relevant training to clinical staff, including new hires.
  • Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
  • Ability to attend to detail, effectively prioritize, and execute tasks in a timely manner.

Universal American Corp. is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.
Required Skills

Mental health, behavioral health, geriatric care
Openings
1

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