Psychiatric Admissions and Referral Specialist

University of Maryland; Glen Burnie (MD); On-site; USD 10,000 - 60,000; Full time

Job summary

A leading academic health system is seeking a Referral Specialist for the Psychiatric Admissions and Referral Center. This role involves coordinating patient referrals, managing insurance authorizations, and ensuring smooth communication in the psychiatric admission process. Candidates should have a background in psychology or related fields with strong problem-solving skills.

Qualifications

• Bachelor's degree required; experience in psychiatric admissions preferred.
• Strong critical-thinking and problem-solving skills essential.
• Knowledge of insurance processes and psychiatric illnesses is beneficial.

Responsibilities

• Coordinate patient referrals and manage admissions in the psychiatry unit.
• Ensure effective communication between referring locations and receiving units.
• Document referral decisions and insurance verifications.

Skills

Critical thinking

Problem-solving

Effective communication

Attention to detail

Education

Bachelor’s degree in psychology, social work, nursing, or related field

Tools

Epic electronic medical records system

Microsoft Office applications

Job description

Job Description

3 shifts per week, 12 hours each: Saturday, Sunday, and Monday 9a-930p. Periodic opportunity for extra shifts to cross cover.

1. Coordinates Psychiatry Transfer Center: Service line/unit-specific lists for referrals to inpatient psychiatry units. Move patient referrals through process.
2. Determining capacity for admissions to maximize patient flow and bed utilization through collaboration with unit leaders and continuous monitoring of capacity (open beds, discharges) and demand (patients who need admission).
3. Reviewing cases for admission with PARC psychiatry medical director or designee.
4. Liasion between referring locations, reviewing clinician, and receiving units to ensure efficient and effective communication.
5. Document management of referral demographic, clinical, and legal documents required for psychiatry admission.
6. Insurance verification and authorization.Preliminary review of insurance to determine if in-network provider. If out-of-network, maintain awareness of need to attempt to secure single case agreement if patient is accepted. Follow any payor-specific rules regarding in-network bed search and timely notification/request procedures.
7. Documentation of referral decisions and review steps.
8. Assist in answeringincoming PARC office calls and respond to caller needs when Administrative Assistant is unavailable due to call volume or when the call is best handled by the Referral Specialist.
   1. Frequent incoming and outgoing calls to request information, communicate decisions, and coordinate complex logistics of patient movement. Incoming calls may be to the PARC office lines or to the Referral Specialist directly.
9. Building Encounter entry in Epic electronic medical record system and related registration functions.
10. Partial Hospitalization Program (PHP)/Intensive Outpatient Program (IOP)
    1. Receive and process new patient referrals. Reviewing referral with the NP/Attending for PHP/IOP. Documenting and communicating referral decisions to referral sources.
    2. Manage PHP/IOP ambulatory schedules in Epic: create/remove patient encounters for all visits.
    3. Determine if authorization is required for PHP/IOP. Obtain initial authorization, if required.

Company Description

This position is located within the Psychiatric Admissions and Referral Center (PARC) in collaboration with the University of Maryland Access Center (UMAC) for the University of Maryland Medical System. Looking for candidates familiar with the psychiatric inpatient admission process for voluntary and involuntary patients to inpatient level of care, including referral management, insurance verification and authorization, and psychiatry admission legal paperwork requirements.

The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org.

Qualifications

Education and Experience

1. 1. Bachelor’s degree in psychology, social work, nursing, or a related health and human services field is required. Associate’s degree: May substitute 2 years of directly related experience in psychiatry admissions for Bachelor’s degree. HS Diploma: May substitute 4 years of directly related experience in psychiatry admissions for Bachelor’s degree.
   2. One-year experience in a hospital or psychiatric treatment setting is preferred.

Knowledge, Skills and Abilities

1. 1. Strong critical-thinking and problem-solving skills required to manage referrals and patient flow: matching individual patient needs to the right bed at the right time in the context of overall service demand and availability of resources.
   2. Effectively manage competing priorities with high reliability and attention to detail.
   3. Interact and communicate effectively verbally and in writing with patients, potential patients, and healthcare professionals in stressful situations while maintaining calm, courteous, exemplary customer service.
   4. Accurate documentation and stewardship of protected health information.
   5. Familiarity with psychiatric illnesses including working knowledge of DSM/ICD diagnostic categories and disorders and psychotropic medications commonly used in treatment of psychiatric illnesses and substance use disorders.
   6. General familiarity with levels of psychiatric care available at UMMS and in the community. Direct callers seeking psychiatry treatment to appropriate resources, including callers in crisis.
   7. Learn and maintain working knowledge of legal and regulatory requirements of hospital-based health care, transfers between health care facilities, patient rights, legal guardianship, procedures for emergency petitions and emergency psychiatric evaluations, voluntary and involuntary psychiatry admissions, involuntary admission hearings, and clinical review panel/forced medication processes.
   8. Learn and maintain working knowledge of insurance prior authorization processes, including third party payor rules and clinical criteria for inpatient, partial hospitalization, and intensive outpatient levels of care.
   9. Proficient in the use of technology to support communication, review of records, and documentation. Requires daily use of telephone, fax, email, secure text messaging, internet navigation including third party online portals, Microsoft Office applications, and electronic medical records system (Epic).

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation

• Pay Range:$21.5-$30.12
• Other Compensation (if applicable):

Review the 2024-2025 UMMS Benefits Guide