Program Evaluation and Benefits Specialist

About the Role

This position serves as a vital bridge between patients and the healthcare system, focusing on securing essential benefits and navigating complex insurance landscapes for individuals with psychiatric and substance use disorders. The role exists to ensure that vulnerable adults receive the comprehensive support they need to stabilize their lives, combining clinical empathy with administrative precision.

In this capacity, you will act as a dedicated advocate, responding promptly to patient requests for benefits assistance. Your day involves a dynamic mix of direct patient interaction and detailed documentation. You will meet with patients to assess their needs, determine the appropriate level of care, and collaborate with AltaPointe programs to facilitate placements. A significant portion of the role involves traveling to patients' homes to provide follow-up care and transporting patients to appointments when necessary.

Crisis management is a core component of this position. You must be able to recognize crisis states, de-escalate situations effectively, and refer patients to the appropriate clinicians or levels of care. Throughout these interactions, you will maintain a courteous, respectful, and compassionate attitude, treating every patient with dignity while adhering to strict privacy and confidentiality standards.

Beyond direct patient care, you will play a key role in program evaluation and data integrity. You will be responsible for entering Behavioral Health Community Care (BHCC) and grant-related data into databases daily, ensuring accuracy and timeliness. This includes documenting all calls, services, and case dispositions in the Avatar electronic health record system. You will actively participate in performance improvement activities and continuously seek ways to enhance data collection and analysis.

Qualifications & Certification

To succeed in this role, you will need a High School diploma and a foundational knowledge of adult psychiatric and substance use disorders. Familiarity with addiction as a primary or secondary illness, cultural diversity, and intellectual and developmental disabilities is essential. You should possess a working knowledge of behavior management, crisis intervention, and psychiatric rehabilitation principles.

A critical requirement for this position is the ability to obtain SOAR (Supporting Older Adults with Disabilities) certification within one month of hiring. Additionally, you must be comfortable navigating benefits and insurance providers, including Social Security, Medicaid, and Medicare, and possess basic knowledge of billing and data analysis tools like Excel.

Commitment to Excellence

AltaPointe is committed to maintaining the highest professional standards. We expect all team members to adhere to company policies, maintain current certifications, and actively participate in ongoing staff education and training. We value flexibility, understanding that grant and DMH deadlines may occasionally alter daily schedules. Our culture is built on the belief that personal values should never inhibit the ability to relate to and care for others, fostering an environment of gentleness, calm, and cooperation.