Diversion Specialist QP
Company: Vaya Health
Posted on: March 17, 2023
LOCATION: Remote GENERAL STATEMENT OF JOB:The primary purpose of
this position is to assure the State's Diversion Referral and
Screening (DRS) project is implemented successfully to increase the
probability of "direct" diversions for the Transitions to Community
Living (TCL) for those members at risk for entry into Adult Care
Homes (ACH). The DRS project will allow Local Management
Entities/Managed Care Organizations (LME/MCOs) to interact with
individuals at risk for entry into ACHs earlier on in the
admission/discharge process. This position is responsible for
providing screenings and case management to individuals referred in
the DRS process. As part of team, this position will screen
members, make appropriate referrals, provide member education, and
divert members from ACHs when possible. This position will promote
an efficient, clinically sound, and person-centered approach to
supporting individuals through this process. Contact with community
stakeholders is significant and the Diversion Specialist is
responsible for ensuring a high level of quality in customer
service, including strong collaborative relationships with
providers and key stakeholders (e.g., Hospitals, DSS, ACHs,
behavioral health and physical health providers, Tenancy Support
providers, internal departments, and natural supports). This is a
mobile position with work done in a variety of locations. The
Diversion Specialist spends a considerable amount of time in the
field and completes required documentation/paperwork at an office
location or in the employee's home (as applicable). ESSENTIAL JOB
- Functions as an independent screener to make the determination
of whether an individual has SMI/SPMI; are eligible for Medicaid or
state-funded services and are offered services whether they move
into the community or reside in an ACH.
- Refers to other specialists for timely assessment as clinically
- Ensures all State mandated tasks related to member disposition
are completed within benchmark timeframes
- Gathers supporting documentation for initiatives upon request
by Supervisor or other Vaya Health staff (with Supervisor
- Ensures timely and thorough documentation of all efforts, both
individual-specific and programmatically, as requested by
Supervisor, and other TCL Team members.
- Possess knowledge of the needs of individuals with a mental
illness, and substance use/addiction disorders and can effectively
work with all individuals with respect on a level that they can
understand and relate to Managed Care Treatment Planning Care
- Enters and maintains data in the State's RSVP system and TCLD
system as applicable
- Ensures Community Integration Plans (CIP) are developed for
members based on State guidelines
- Provides education and information to TCL eligible individuals
of all the available alternatives to entry into an ACH during the
- Develops and produces clear documentation that each
individual's informed choice, drove their decision to live in the
setting of their choosing, especially if they choose to transition
into an ACH.
- Refer all TCL eligible individuals who choose to be admitted to
an ACH, for In-Reach.
- Convenes key providers and others in a collaborative approach
to address needs of the individual and ensure appropriate treatment
planning and evaluation
- Promotes person centered practices, including use of
person-centered language and person-centered tools in planning
- Identifies gaps in services and intervenes to ensure that the
individual receives appropriate care
- Focuses on achieving positive outcomes for individuals,
regardless of disposition status, including reduction in high-risk
events and inappropriate service utilization
- Ensures that services for the individual are coordinated across
the Vaya Health system and with other systems, including primary
- Provides support and direction for the individual and his/her
treatment team to ensure quality service and community
- Educates others about various housing options/resources and how
to access them Collaboration
- Partners with individuals/families, providers and community
stakeholders, as applicable, to create solutions to
issues/concerns, barriers to progress, etc.
- Works in partnership with other Vaya Health departments to
address identified needs and opportunities to improve member
outcomes Knowledge, Skills and Abilities
- High level of diplomacy and discretion is required to
effectively negotiate and resolve issues with minimal
- Exceptional interpersonal skills and highly effective
communication ability in both written and oral form
- Problem solving, negotiation and conflict resolution skills are
essential to balance the needs of both internal and external
- Skilled at shifting between macro and micro level planning,
maintaining both the big picture and seeing that the details are
- Considerable knowledge of the MH/SU/DD service array provided
through the network of providers with additional knowledge in
Medicaid B and C waivers, and NC DMA Clinical Coverage policies is
- Must be detail oriented, able to organize multiple tasks and
priorities, and to effectively manage projects from start to
- Ability to change the focus of activities, when needed, to meet
- Proficiency in Microsoft Office products (such as Word, Excel,
Outlook, etc.) is required.
- Excellent written and verbal communication skills.
- Schedule Integrity combined with commitment to adhere to
established deadlines. Work is performed with considerable
independence, with most work performed in the community and away
from the office. Employee is familiar with values and goals of TCL
and Care Coordination and minimal daily instruction is required.
Formal supervision is scheduled monthly on an ongoing basis and
informal supervision occurs as needed. This is a mobile based
position which primarily occurs during normal business hours.
Employee is required to have and maintain high speed internet
access (with a minimum download speed of 10Mb/s) in home residence
as a condition of employment. The expense for installation and
monthly maintenance of this internet access will be the
responsibility of the employee. Driving is an essential function of
the position. Travel within the community is required and
after-hours meeting attendance should be expected upon occasion.
Vaya Health reserves the right to call upon this employee during
non-business hours as needed to meet the demands of the position.
QUALIFICATIONS & EDUCATION REQUIREMENTS:Bachelor's degree in
Psychology, Social Work, Counseling, or similar field required.
Must have at least two years post-degree progressive experience
providing similar services to the populations served (MH/SU/IDD).
- Close visual acuity to perform activities such as preparation
and analysis of documents; viewing a computer terminal; and
- Physical activity in this position includes crouching,
reaching, walking, talking, hearing and repetitive motion of hands,
wrists and fingers.
- Sedentary work with lifting requirements up to 10 pounds,
sitting for extended periods of time.
- Mental concentration is required in all aspects of work.
KNOWLEDGE, SKILL & ABILITIES:
- Ability to multitask and prioritize to manage multiple projects
on tight timelines
- Ability to take ownership of projects from planning through
- Strong attention to detail and superior organizational
- Ability to understand the strategic direction and goals of the
department and support appropriate processes to facilitate
achievement of business objectives
- Comfort with adapting and adjusting to multiple demands,
shifting priorities, ambiguity, and rapid change
- Well-developed capabilities in problem solving and crafting
- A result and success-oriented mentality, conveying a sense of
urgency and driving issues to closure
- An ability to initiate and build relationships with people in
an open, friendly, and accepting manner
- An innate drive to innovate and optimize the use of available
- An ability to be a responsible self-starter
- Proficiency with Microsoft Office proficiency, to included
Excel, data analysis, and secondary research
- Knowledge of and experience with managing an operations system
RESIDENCY REQUIREMENT:This position is required to reside in North
Carolina or within 40 miles of the North Carolina border. SALARY:
Depending on qualifications & experience of candidate. This
position is non-exempt and is eligible for overtime
DEADLINE FOR APPLICATION: Open Until Filled
APPLY: Vaya Health accepts online applications in our Career
Center, please visit https://www.vayahealth.com/about/careers/.
Vaya Health is an equal opportunity employer.
Keywords: Vaya Health, Burlington , Diversion Specialist QP, Other , Burlington, North Carolina
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