Part-Time Utilization Review Alcohol and Drug (AOD) Clinician (Venice, CA)

Part-Time Alcohol and Drug (AOD) Utilization Review Clinician

(Part-Time) Reporting to the Clinical Manager, the Alcohol and Drug (AOD) Utilization Review Clinician is responsible for implementing and maintaining Utilization Management and its philosophy in their area of operation and influence.  The Utilization Review Clinician functions as part of the multidisciplinary treatment team and has the responsibility to assist the team in appropriate access and use of internal and external resources.

SCHEDULE

  • Variable

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Perform both internal and external record reviews as part of daily department operations.
    • Cooperates with Admissions to complete certifications as needed and documents outcome in certification record.
    • Performs concurrent utilization review with insurance companies and relevant payers, documenting outcome of same in the certification record.
    • Obtains and documents authorization for services not covered under per diems and communicates directly to physicians/clinician.
    • Maintains an appropriate and ethical performance of reviews, both internal and external.
  • Develop and maintain professional relationships with treatment team members to enhance the role of Utilization Management within the organization.
    • Communicates to appropriate members of the treatment team the status of the cases assigned with mandatory reporting to the physician or team designee.
    • Communicates need for Peer Reviews between physician and payers, facilitating as needed; completes documentation.
    • Attends team/staff meetings per program scheduling, as clinically indicated.
  • Assist in preparedness for surveys by regulatory agencies and payers.
    • Audits/reviews charts-depth and intensity to be determined by data collection reports.

EDUCATION/EXPERIENCE/CREDENTIALS

  • AMFT or ACSW with current California Board of Behavioral Sciences (BBS) Registration required.
  • Evidenced Based Trained/Certified in MAP, TF-CBT, SS Preferred
  • Preferred strong clinical foundation, EMR experience, knowledge of Drug Medi-Cal expectations towards clinical documentation, case management experience related to community linkages for mental health, medical and housing services
  • Must maintain a valid CA Drivers' License, have proof of automobile insurance and maintain a safe driving record based on Phoenix House policy.

KNOWLEDGE/SKILLS/ABILITIES

  • Demonstrated commitment and adherence to Phoenix House Mission, Vision, and Values: I CARE For– Integrity, Collaboration Appreciation, Respect, Excellence, and Forward-Thinking
  • Proficiency in MS Office systems
  • Ability to utilize an electronic medical record
  • Proficiency with SPAC, DMH, Community Care Licensing, and other governing bodies
  • Establish and maintain effective working relationships with others
  • Communicate effectively with others both orally and in writing
  • Ability to work effectively in a fast-paced changing environment
  • Ability to establish and consistently enforce appropriate boundaries with patients
  • Ability to model positive behavior and demeanor
  • Understanding of addiction, co-occurring models, and treatment modalities
  • Understanding of adult/adolescent development and family systems
  • Excellent time management and organizational skills
  • Ability to be flexible; problem solver, self-directed; customer service-oriented, and collaborative
  • Skills and ability to engage and develop a rapport with patients and families of various backgrounds
  • Bilingual in Spanish preferred.

#ZR

Job Location: Venice, CA

Job ID: 92