Description
Health Affiliates Maine has an opening for an Affiliate Relations Specialist I to join their team! This is a full-time, hourly (non- exempt), role.
Roles and Responsibilities:
- Complete timely preliminary clinical audits using the Audit tool to be reviewed by the Assistant Director (this includes tracking audit completion and timelines, uploading paperwork/interaction log and providing affiliate correspondence).
- Support the mentoring program by providing administrative support to related notifications, consultants etc.
- provide welcome emails to new affiliates.
- Complete affiliate check-ins related to inactivity per Inactivity procedure.
- Review substance use qualifications report and notify affiliates that need to submit compliance documents (copying the Assistant Director).
- Tracking supervision documentation and reminding affiliates, bringing noncompliant affiliates to the Assistant Director.
- Complete the 90-day discharge report and first notifications to affiliates.
- Complete random audits on medical necessity measures on affiliate records using Medical Necessity template.
- Using the knowledge library and other templates, research and respond or ensure response to affiliate inquiries sent by phone, voicemail, electronic health record, email and/or ticketing system, forwarding those that need clinical response to the Assistant Director.
- Submit critical incident and mandated DA reports provided by affiliates in designated system.
- Provide courtesy calls to affiliates as needed per procedures (such as when an affiliate is late or overdue on items).
- Prepare/Support completion of the weekly update for Assistant Director to publish weekly to the affiliate hub.
- Provide administrative support on Affiliate relations projects, including minute taking when needed.
- Check references as needed for conditional affiliate applications.
- Coordinate meeting links and minutes as requested.
- Participating in EHRYW change and improvements as relevant to affiliate role.
- Participate in marketing activities for the affiliate program as requested by leadership.
- Provide back up to the Program Integrity department on continued stay reviews or discharges. (Complete a few each week to maintain competency).
- Document interactions with affiliates as directed by department leadership or applicable policy/procedure.
- Provide affiliate relations support for other HAM departments (billing, operations, program integrity, case management, referrals/reception, human resources, leadership, clinical support) as indicated by department leadership and/or policies and/or procedures/workflows.
- Assist the Assistant Director with completion of affiliate contract evaluations, completing the first portion of review.
- Assist with Affiliate-focused projects interdepartmentally as requested (such as those related to enhancing the E.H.R. referrals or other processes).
- Maintain and apply knowledge of MaineCare, Contracting, Licensing, and affiliate contractual obligations to HAM for the populations served by our affiliates.
- Understand the basics of billing and MaineCare authorization (Acentra) processes to assist affiliates in understanding policies and procedures related.
- Be prepared for and actively participate in meetings with your supervisor, department and agency wide.
- Protect and maintain the confidentiality of client records and information, following HIPAA, HITECH regulations and 42 CFR.
- Log/Maintain records of affiliate interactions and complete other forms, paperwork when necessary or per department procedures.
- Attend and participate in clinical and administrative supervision and training as prescribed by your certification and/or license and Health Affiliates Maine.
- Participate in offerings to our affiliates, such as training and the Consortium.
- Maintain knowledge of the Rights of Recipients of Mental Health Services and the AMHI Consent Decree.
- Practice a trauma-informed approach to care including maintaining a calm, non-defensive attitude to de-escalate crisis situations, encouraging the health, safety, and welfare of clients, and ensuring self-determination.
- Participate in mandated reporting per agency policy and Maine Law including the review and submission of critical incidents, reportable events, and DA reports.
- Complete all other duties assigned by leadership and supervisor.
For hybrid or fully remote positions, employees must maintain a designated home workspace that is private, secure, HIPAA-compliant, and ergonomically appropriate for remote work. This includes having reliable internet access and the ability to protect confidential and sensitive information at all times. Reasonable accommodations may be provided to individuals with disabilities in accordance with applicable law.
Requirements
Minimum Education/Experience Qualifications:
- A bachelor's degree in social work, Psychology, or related field
- Active MHRT-C, LSW or CADC credential/licensure
- At least 2 years of clinical administrative experience at a behavioral health organization