Clinical Reviewer – PASRR – HigherEdJobs

Job Summary

Under the general supervision of the Associate Director, or designee, the Clinical Reviewer – PASRR is responsible for reviewing
submitted referrals and any accompanying clinical documentation to the Pre-Admission Screening and Resident Review (PASRR) unit for
completeness. The Clinical Reviewer- PASRR may also complete Abbreviated Level II evaluations in accordance with relevant guidelines and
regulations. This position facilitates individuals with suspected serious mental illness (SMI), seeking admission to or currently residing
in a nursing facility, receive an in person or abbreviated evaluation and nursing facility placement determination.

Major
Responsibilities

• Participate as an active member of a multi/inter-disciplinary team to evaluate and determine the
  appropriateness of nursing facility placement for individuals with suspected SMI.

• Complete thorough review of all
  referrals and accompanying clinical documentation for completeness and determines if the referral can be moved to an abbreviated or full
  PASRR Level II evaluation.

• Demonstrate an ability to use critical thinking skills to identify when to conduct additional
  outreach or review on assigned cases and when to escalate to assigned supervisor.

• Complete Abbreviated Level II
  evaluations on an individualized basis, but in accordance with the most current federal rules, regulations, and evaluative criteria and
  required timeframes.

• Review and document all relevant information into data system applications in accordance with program
  guidelines and regulations.

• May participate in the preparation of appeals for determinations made through the PASRR
  process.

• 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 and other
  programs/organizations involved in the provision of services.

• Maintain positive working relationships with individuals
  served, and relevant informal supports, provider organizations, and state agencies.

• Maintain the confidentiality of all
  business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations.

• Participate in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.

• Participate in training and mentoring of new clinical reviewer staff.

• Comply with established departmental
  policies, procedures and objectives.

• Comply with all health, safety and program regulations and requirements.

• May participate in public relations efforts, attending conferences and meetings as needed.

• Perform other similar
  and related duties as required or as directed.

Required Qualifications

• RN, LPN or social worker
  licensed to practice in Massachusetts with an appropriate degree

• 3-5 years work experience with at least 3 recent years
  providing direct service or case management

• Expertise in working with individuals with mental health behavioral health
  issues.

• Ability to understand and utilize resources for problem solving, in order to deal with problems involving multiple
  variables, effectively prioritizing and executing tasks in a high pressure, fast paced environment.

Preferred Qualifications

• Extensive experience with program related services/populations
  preferred

Supervision

Supervision Received

Will be supervised by clinical
coordinator.

Supervision Exercised

This position does not include supervisory responsibilities.

Environmental Working Conditions

Remote position which requires working at computer for all tasks.

Posting Disclaimer:
This job posting outlines the primary responsibilities and qualifications for the role but is not
intended to be an exhaustive list. Duties and expectations may evolve in response to the needs of the department and the broader
institution.

In alignment with our commitment to pay transparency, the base salary range for this position is listed above
(exclusive of benefits and retirement). At UMass Chan Medical School, final base salary offers are determined based on a combination of
factors, including your skills, education, and relevant experience. We also consider internal equity to ensure fair and consistent
compensation across our teams.

Please note that the range provided reflects the full base salary range for this position. Offers are
typically made within the midrange to allow for future growth and development within the role.

In addition to base pay, UMass Chan
offers a comprehensive Total Rewards package, which includes paid time off, medical, dental, and vision coverage, and participation in a
401(a)-retirement plan, with the option to contribute to a voluntary 403(b) plan.

UMass Chan welcomes all qualified applicants and
complies with all state and federal anti-discrimination laws.