Clinical Reviewer

Job Duties & Responsibilities

Clinical Recommendations:

• Provide recommendations based on guidance from Medical Directors for prospective patients and their families.

• Evaluate admission screenings and recommend appropriate programs, levels of care, and delivery modes.

• Review admission materials, including interviews, transfer documentation, external provider records, and prior treatment summaries.

• Demonstrate understanding of Rogers' treatment programs, inclusion/exclusion criteria, levels of care, and treatment delivery modes.

• Communicate recommendations to team members, providers, and patients/families professionally and accurately.

Mandatory Reporting:

• Implement knowledge of System policies and state laws for reporting suspected abuse or neglect.

• Ensure compliance with mandatory reporting requirements across all locations.

Leadership in Clinical Processes:

• Evaluate outcomes of departmental initiatives and refine review processes.

• Assist with process development and participate in interdisciplinary meetings.

• Facilitate communication and provide guidance to the team on clinical reasoning and recommendations.

Professional Communication:

• Collaborate with departments and external agencies as needed.

• Report and prioritize data effectively for immediate or postponed action.

• Address and resolve problems with referents, patients, and team members calmly.

• Maintain positive relationships with medical staff and providers for case communication.

Team Collaboration:

• Support team development and educate Patient Access and Admissions teams.

• Communicate respectfully and assertively with all personnel.

• Promote a team-oriented approach to patient access and admissions.

Participation in Improvement Initiatives:

• Engage in projects to improve skills and processes.

• Apply Rogers Operating System (ROS) principles and participate in daily huddles.

• Create and apply ROS projects for measurable improvements.

Regulatory Compliance:

• Understand and apply Joint Commission and state regulations.

• Educate self and others on compliance requirements for outpatient programs.

Safety and Emergency Protocols:

• Maintain patient and facility safety by following System guidelines and emergency protocols.

• Report safety concerns and incidents promptly.

Committee and Site Participation:

• Attend site committees and actively contribute to discussions and improvement activities.

• Demonstrate organizational skills and effective communication in meetings.

Additional Responsibilities:

• Complete required training, orientation, and annual competencies.

• Document accurately in patient medical records.

• Participate in on-call rotation and assist with student/intern training if applicable.

• Perform other duties as assigned while supporting the Mission and goals of the organization.

Additional Job Description:

Education/Training Requirements:

• Master's Degree in Psychology, Nursing, Social Work, or related field, from an accredited school of Social Work, Professional Counseling, or Family Therapy with a minimum of two (2) years' experience in health care and at least two (2) years in a psychiatric setting, preferred.
• Full, independent licensure as a Registered Nurse, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW) or equivalent in state practicing, i.e., LPCC, LMHC.
• Previous admitting triage experience required.
• Attend all mandatory in-services and other in-services relevant to the position. Be responsible for all educational requirements and related obligations pertaining to the license of the program/unit license regulatory requirements governing the program(s).

With a career at Rogers, you can look forward to a Total Rewards package of benefits, including:

• Health, dental, and vision insurance coverage for you and your family
• 401(k) retirement plan
• Employee share program
• Life/disability insurance
• Flex spending accounts
• Tuition reimbursement
• Health and wellness program
• Employee assistance program (EAP)

Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Rogers Behavioral Health. To link to the Machine-Readable Files, please visit Transparency in Coverage (uhc.com)