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Managed Care Coordinator – Friendship Academy

The Watson Institute is hiring a full-time Managed Care Coordinator at Friendship Academy, a special education school for children with emotional and behavioral disorders located 4 miles east of Pittsburgh, PA. The Managed Care Coordinator is responsible for ensuring compliance with partial hospital and outpatient documentation in relation to billing, quality of care, appropriateness or care, and licensing. This position works Monday through Friday, 7:30 a.m. to 3:30 p.m.

Learn more about what it’s like to work at the Watson Institute!

Employment Type: Full-time

Responsibilities:

Building and maintaining a close relationship with the managed care organizations that serve our clients, including:

  • Responding to case inquiries
  • Resolving disputes
  • Problem solving high risk cases
  • Coordinating quality assurance audits
  • Disseminating feedback to partial hospital clinicians
  • Coordinating completion and submission of continued stay authorization requests
  • Representing Friendship Academy at quarterly school-based provider meetings

Being the first point of contact for new and potential clients:

  • Conducting initial interviews and tours for prospective clients and their families, in collaboration with the Education Liaison
  • Conducting an initial intake interview and best practice psychiatric evaluation in collaboration with Psychiatrist to determine appropriate level of care
  • Completing initial psychiatric evaluation documentation and initial treatment plan
  • Completing and submitting initial request for insurance authorization
  • Collaborating with Clinical Supervisor to determine case assignments

Ensuring compliance in daily administration and documentation of services:

  • Maintains familiarity with the licensing requirements of partial hospital and outpatient programming, assures compliance and updates as necessary
  • Trains incoming staff on quality documentation standards
  • Assures quality and timely completion of treatment notes
  • Assures client/family signatures are obtained in a timely manner on all encounter forms and treatment plans
  • Completes annual psychiatric evaluation documentation in collaboration with Psychiatrist
  • Conducts record reviews to ensure ongoing compliance in partial and outpatient programs
  • Leads, organizes, plans, and coordinates preparation for all audits, including quality assurance, licensing, and fraud, waste and abuse

Other duties as assigned

Requirements:

  • Licensed Mental Health Professional (LSW, LPC)
  • Experience conducting psychiatric evaluations
  • Strong organizational skills and attention to detail
  • Current Acts 34, 114 and 151 clearances required