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PASRR Level II Evaluator

KEPRO

This is a Full-time position in Fresno, CA posted December 2, 2020.

nnKEPRO is a rapidly growing national quality improvement and care management organization.

We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.nn nnPASRR Level II Evaluatornn nn**HIRING FOR FULL-TIME, PART-TIME AND PRN**nn nnSummary Description nn nnConducts face to face assessments for individuals with mental illness admitted to or residing in Medicaid certified hospitals or Nursing facilities.

Provides recommendations for mental health treatment and appropriate placement as well as needed specialized services.

Also, ensures day-to-day processes are conducted in accordance with NCQA, URAC and other regulatory standards.nn nnAccountabilities nn 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 Manager and/or Medical Director.

Respond to state inquiries 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.

nn The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time. nn nnQualifications/Educationnn Licensed Clinical Social Worker, Licensed Clinical Psychologist, Nurse Practitioner or other qualified Licensed Mental Health Professional approved by state PASRR authority.

Graduation from an accredited College with relevant Degree Program.  nnKnowledge, Skills, Abilities nn Knowledge of Federal Regulation 42 CFR, Chapter 483.

Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in California.

Knowledge of standards of practice related to determination of Level of Care.

Knowledge of standards of practice related to mental health, geriatric and other disorders typically requiring long term care placement.

Knowledge and understanding of public sector services and supports.

Computer proficiency in Microsoft Excel, Word and Outlook.

Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.

Ability to utilize computer equipment and web based software to conduct work.

Ability to interact with various office staff as needed to support necessary workflows.

Ability to interact with healthcare professionals, patients, their families and other supports.

Ability to communicate effectively to individuals and groups through spoken, written and electronic media.

Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.

Assesses and analyzes psychological, emotional, behavioral and physical functioning.

Develops level of care recommendations based upon clinical evaluations.

nnExperiencenn Minimum of 3 years’ experience in the assessment and diagnosis 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.

nnMental and Physical Requirements               nn nnThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the statenn