Responsible for completion of clinical evaluations of individuals referred by acute care or nursing facilities for a Level 2 pre-admission screening or resident review. These are individuals with a suspected or confirmed mental illness and who are seeking admission to a Medicaid certified nursing facility, or who are currently residing in a nursing facility whose physical and/or mental functioning has significantly changed. Communicates with service providers, reviews available medical records, consults with family or other collateral sources, and interviews the patient. Uses a web based application to conduct an assessment and provide recommendations for a plan of care.
Ensures accurate PASRR evaluations through accurate clinical assessment of the patient, relevant records, and collateral sources of individuals with suspected or confirmed mental illness to determine the presence of a Serious Mental Illness (SMI), as defined by 42 CFR 483.102(b)(1). Ensures accurate PASRR review completion by determining appropriate level of care based on the patient’s physical, behavioral, and psychological functioning.
Ensures compliance with necessary workflow include re-review of records based upon input from QA Director and/or Medical Director.
Respond to inquiries from Consulting Psychologists regarding evaluations conducted.
Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
Review current literature, regulations, and research related to long term care, mental illness, medical conditions, and geriatrics.
LCSW, LMFT, Licensed Clinical Psychologist, NP, or other qualified licensed mental health professional
Minimum of 3 years’ experience in the assessment, diagnosis, and treatment planning of individuals with mental / psychiatric disorders, including complex differential diagnoses that are related to substance use, medical conditions, cognitive issues, and dementia.
Experience with geriatric population is preferred
Federal Regulation 42 CFR, Chapter 483
Psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in California.
Standards of practice related to determination of Level of Care.
Standards of practice related to mental health, geriatric/other disorders typically requiring LTC placement
Public sector services and supports
Computer proficiency in Microsoft Excel, Word, and Outlook.
This position requires travel to various facilities to conduct evaluations. A valid, unrestricted CA drivers license and proof of car insurance is required
We are a leading quality improvement and care management organization. We offer innovative and outcomes-focused solutions to reduce the unnecessary use of health care resources and optimize the quality of care for public and commercial clients. KEPRO’s tailored programs maximize members’ quality of life, and realize greater cost savings for members and clients alike.