Rogers Behavioral Health

Clinical Reviewer


PayCompetitive
LocationOconomowoc/Wisconsin
Employment typeFull-Time

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  • Job Description

      Req#: R2617
      Schedule: Tuesday - Saturday, 10:30 am - 7:00 pm with some flexibility on the Saturday hours.

      The Clinical Reviewer receives and reviews prospective patient screening materials (to include admissions screening interview [ASI] and various internal or external records), delivers clinical/programmatic recommendations to department and division team members, collaborates with providers and performs other duties as directed by their supervisors.

      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)

  • About the company

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