Clinical Reviewer DMH PASRR Hybrid; South Shore​/Boston

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When you join the UMass Chan Medical School team, you join us in advancing together to improve the health and well-being of our diverse communities throughout Massachusetts and across the US and the world.

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Clinical Reviewer DMH PASRR - (Hybrid; South Shore/Boston)
Job Number
:
Category: Healthcare
Location
:
Shrewsbury, MA
Shift: Day
Exempt/Non-Exempt: Exempt
Business Unit: For Health Consulting
Department: For Health Consulting - Community Service - W401950
Job Type: Full-Time
Num. Openings
: 1
Post Date
:
Jan. 23, 2025

Under the general supervision of the Associate Director, or designee, the Clinical Reviewer II is responsible for completing Pre-Admission Screening Resident Reviews (PASSR) Level II Evaluations by conducting face to face evaluations and reviewing medical records, in accordance with relevant guidelines and regulations. This position ensures that individuals with mental illness (MI), seeking admission to or currently residing in a nursing facility, receive an in-person evaluation and nursing facility placement determination.

• Upon suspicion of MI conduct in-person evaluations to confirm the presence of MI, whether a nursing facility is the most appropriate setting and whether the individual has a need for specialized services.
• Conduct completed evaluations prior to individuals nursing facility admissions; completed evaluations on individuals residing in a nursing facility when there are significant changes that signify the need for an updated evaluation.
• Complete evaluations on an individualized basis, but in accordance with the most current federal rules, regulations, and evaluative criteria.
• Communicate all evaluation findings to applicants, residents and/or guardians in an understandable manner and language.
• Communicate determinations that identity a need for specialized services to the facility, agency, or referrals source, within appropriate timelines and data transmission policies.
• Contact providers, state agency offices, and applicants/participants to obtain information and records needed to conduct a comprehensive clinical review of the case and final determination
• Review and document all relevant information into data system applications in accordance with program guidelines and regulations
• Maintain individual records documenting all applicant/participant encounters and contacts; write clinical summaries
• Prepare and respond to requests for statistics and resource/service data
• 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/For Health Consulting procedures and HIPAA regulations
• Participate in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
• Comply with established departmental policies, procedures and objectives.
• Comply with all health, safety and program regulations and requirements.
• Perform other similar and related duties as required or as directed.

• Masters degree in social work; mental health counseling; related…