Patient Access Manager

About the role

The Patient Access Manager at Conexiones is an essential member of the organization that focuses on an open access model. The Patient Access Manager is responsible for conducting critical processes related to referrals, intakes, census, and client services. The Patient Access Manager will be responsible for overseeing incoming external, internal, and self-referrals; maintaining census at capacity; and ensuring the MAT process and medication management are complete before the client’s intake. The Patient Access Manager will work closely with the Conexiones Program Director, Chief Operating Officer, Chief Clinical Officer, and external providers to ensure incoming patients meet eligibility criteria. This process includes quality assurance tasks such as ensuring the processes of intake and admissions are being followed, waitlists are up-to-date, beds are filled, referral/application data is entered, reviewing documents to ensure all necessary information is obtained and uploaded, checking insurance eligibility, and communicating with the referral source.

Following Casa Esperanza’s integrated care model, the Patient Access Manager will communicate admission information and complete referrals to other Casa Esperanza services for which the client may qualify. Supports vulnerable patient populations (recently incarcerated, recently homeless, in need of withdrawal management and stabilization, lacking insurance) in accessing culturally competent, evidence-based, and patient-centered trauma-informed care. All documentation will be stored in Evolv, our electronic health record and billing database. This position will work with or report directly to the Director of Patient Access and the Conexiones Program Director.

The Patient Access Manager will provide supervision of patient access at the Tewksbury campus and ensure a seamless, cohesive workflow with the rest of the Patient Access Department. Key areas of responsibility include quality assurance of all clients' charts, enforcing confidentiality, and providing a safe environment for all staff and clients.

What you'll do

Intake Responsibilities:

• Build and maintain relationships with internal and external referral sources
• Maintain awareness of current census and caseload targets and expectations
• Ensure timely access to services and work with clinical team to remove barriers to care
• Oversee initial assessment, and follow-up care with internal and external providers to ensure timely access to services and operations for a dynamic, open-access, integrated care clinic, including ASAM, biopsychosocial, and Urgent Care Triage as needed
• Identify individuals in crisis and engage clinical team for crisis response
• Manage communication and coordination amongst internal and external providers to ensure timely access to care, including the prioritization of high-risk/high-need clients
• Manage Patient Access Conexiones
• Maintain and update any admission documentation required by Casa Esperanza or licensing agencies in a complete and accurate manner
• Serve as a resource for resolving problems related to registration, demographic, and insurance errors, and verify insurance eligibility
• Adhere to all HIPAA and 42CRF laws following all confidentiality and protected health information regulations
• Ensure data entry and scanning of all referrals, intake, and other pertinent documentation into Evolv.
• Implement BSAS and Medicare regulations and process
• Ensure completion of BSAS Intake and Enrollment Assessment in patient’s electronic health record
• Review client records for completeness of client insurance information and proper signature
• Manages MAT for patients coming in to care, including dosing letters, identification and communications with home clinics
• Coordinates guest dosing orders with patients’ home clinics in accordance with guest dose procedures.
• Work collaboratively with the Program Manager on daily, weekly, and monthly occupancy reports.
• Other duties as assigned.

Clinic Operations

• Work closely with the Conexiones Program Director to ensure an exceptional level of service is delivered to all Casa Esperanza clients
• Work closely with the Patient Access Manager at Roxbury, Residential Programs to ensure that meet all licensing, regulatory, accreditation, and funder standards and requirements
• Coordinate to ensure room utilization system that will effectively support the growing need of the program