Conduct utilization reviews, assess clinical appropriateness and medical necessity, authorize services, and monitor treatment plans and service use for behavioral health consumers. Coordinate complex care with providers and community partners, support referrals and transitions across levels of care, and document outcomes while ensuring compliance with applicable requirements.
The evaluator conducts mental health assessments and PASRR examinations to determine the appropriate level of care for individuals seeking nursing facility admission. They develop individualized therapy programs and provide clinical recommendations based on comprehensive medical and social history reviews.
The Director of Residential Services manages services for individuals receiving SMI/IDD community living support and personal care in specialized settings. They oversee compliance, strategic planning, care coordination, and the implementation of clinical quality improvement strategies.
