Job Description

Summary/Objective:


The Escalation Specialist will be assigned members directly to provide short-term intervention, de-escalate crises, and stabilize youth and families before transferring them to the appropriate Care Coordinator. This role works closely with the Clinical Supervisor, Care Coordinators, and Operations Managers to resolve complex member issues quickly and implement effective conflict resolution and stabilization plans. Boundless staff, community members, and other service and support providers via video conferencing, telephone, electronic communication and may have limited face-to-face engagement. Escalation Specialist will create and maintain a resource database for all staff to utilize, including maintaining an updated weekly "open" beds, respite lists for OhioRISE members and their families. Escalation Specialist supports the Operations Manager with compliance responsibilities.


1.Works with Clinical Supervisor, Care Coordinator & Operations Managers and/or Supervisors to ensure deadline dates and steps are adhered to for all Aetna/ODM applications. Supervise clinical team care coordinators who work directly with high acuity and crisis members and families.


2.Respond to and be available for clients and families in crisis, as needed, including referencing the crisis plans and facilitating the appropriate linkage to de-escalate the crisis.


3.Engages with Child and Family Team at the request of a Prior Authorization for a PRTF placement. Completes the Prior Authorization through completion including obtaining additional clinical documentation and sharing with identified providers by the PRTF Placement Team. Continues to support the Supervisors and Care Coordinators through the PRTF placement to discharge.


4.Engages with Child and Family Team at the request of an out of home placement and/or need for Multi System Youth waiver application. Completion with assigned Care Coordinator of the MSY application. Tracking the monthly updates of the MSY invoices and tracker to ensure that invoices and updated applications are submitted appropriately and timely with the assigned Care Coordinator.


5.Works collaboratively with care coordinators, supervisors and clinical supervisor in managing flow of Flex Funds/PPL, MSY, 1915c Waiver and PRTF cases, including reviewing, monitoring the collection of information, documents and extension requests are all complete, accurate and submitted within the appropriate timelines.


6.Will monitor IMS reports submitted by care coordinators for accuracy and updates.


7.Create a database with all the application data and share reports from this database with the supervisors.


8.Will assist the Operations Manager with the OhioRISE I Am Boundless monthly audit and ODM/Aetna audits.


9.Monitor completion of all application documentation, including gathering and reporting health and outcomes data.


10.Co-Coordinate subdelegate contracts alongside Operations Manager and ensure team members meet OhioRISE engagement, documentation, and contract requirements.


11.Escalation Supervisor is responsible for ensuring the care coordinators meet all expected timelines and outcomes, including completing assessments and applications for PRTF.


12.Monitor, review and ensure all MSY funding applications, 1915c Waivers and Flex Fund applications are complete before submitting to Aetna and Ohio Department of Medicaid.


13.Monitor, review and ensure referrals and linkages to appropriate services and supports, including natural supports, along the continuum of care are completed. Monitor the transition, as appropriate, of youth and families/caregivers out of the OhioRISE program.


14.Conduct ongoing community resource development to identify formal and informal resources in the communities served, initially and on an ongoing basis, paying particular attention to the availability of culturally responsive resources.


15.Create a resource database that will be shared with the coordinators and maintained weekly with up-to-date information on open beds, respite etc. for members and their families.


16.Administer CANS assessments when necessary.


17.Other duties as assigned.


Skills, Knowledge & Abilities:

High level of professionalism. Excellent organizational skills with the ability to stay focused and meet deadlines. Ability to prioritize multiple tasks. Ability to follow all company policies and procedures. Advanced computer skills with the ability to learn new software and reporting systems. Professional telephone etiquette. Must be able to show tact and diplomacy when dealing with team and community members. Maintain a positive and supportive work environment Appropriate and professional language used in all situations

Qualifications:


1.Minimum of bachelor's degree in social work or related human service field or comparable experience in the human service field.


2.Three years of experience in children's behavioral health, child welfare, developmental disabilities, juvenile justice, or a related public sector human services or behavioral healthcare field, providing community-based services to children and youth and their families or caregivers.


3.Experience in one or more of the following areas of expertise:

Family systems Community systems and resources Case management Child and family counseling or therapy Child protection Child development Training in cultural competency or the ability to complete such within 90 days of hire. One year of supervisory or management experience.

4.CANS Certification


5.Demonstrated skill in coordinating crisis communications, problem solving, and relationship building with members and their guardians.


6.Strong knowledge of and genuine respect for youth and adults with mental health issues and a firm commitment to empowering their families.


7.Strong communication and writing skills.


8.Highly organized, detail oriented and can effectively manage multiple priorities simultaneously.


9.Demonstrated ability to work effectively with internal and external individuals, including other professionals in the community. 10. Work effectively as a member of a team.

Required Licensure/Certification:

Valid Ohio Driver's License with Ohio Bureau of Motor Vehicles - No more than 5 points on driving record. Valid car insurance.


Current High-Fidelity Wrap-Around and CANS Assessor training or the ability to complete such within 90 days of hire.


Work Environment:


1.Limited day travel within the 4 OhioRISE catchment counties and in other locations within the state as directed and approved.


2.This role routinely uses standard office equipment such as computers, phones, and photocopiers.


Physical Demands:


1.The physical demands described here represent those that an employee must meet to perform the essential functions of this job successfully. While performing the duties of this job, the employee is regularly required to talk and listen.


2.The employee frequently is required to stand, walk, and reach with hands and arms.

Position Type/Expected Hours of Work:

This is a full-time position, and the hours of work and days are Monday through Friday, 8:30 am to 5:00pm. Evening and weekend work may be required as job duties demand based on needing to link an individual or family in crisis to the appropriate resources or perform initial outreach to a crisis referral.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change with or without notice.