Manage the end-to-end PRP admissions process from referral acceptance through intake, assessment, and initial rehabilitation planning. Coordinate insurance authorizations and ensure all documentation meets Medicaid and COMAR compliance standards for a clean handoff to operations.
Requirements summary
Requires a CPRP or LMHP credential and DLA-20 certification (or ability to obtain it within 30 days). Candidates must have experience in behavioral health assessments and a valid Maryland driver's license for community-based work.
professional certificatepostgraduate degreeCase ManagementPatient AdvocacyHIPAA ComplianceRegulatory ComplianceElectronic Health RecordsClinical DocumentationPsychosocial AssessmentRehabilitation PlanningInterdisciplinary CoordinationInsurance AuthorizationPerson-Centered PlanningMedical Necessity DocumentationCrisis ScreeningBehavioral Health IntakeMedicaid Eligibility VerificationDLA-20 Assessment
Job description
Advocate Support Services, Inc. is hiring a full-time Admissions & Assessment Specialist to support our Maryland community-based Psychiatric Rehabilitation Program (PRP).
This role owns the credentialed front-end PRP admissions process from referral acceptance through intake, admission-readiness verification, PRP assessment, DLA-20 assessment, initial Individual Rehabilitation Plan (IRP) development, initial insurance/payer authorization submission and follow-through for new admissions, and handoff into PRP services. The right candidate is organized, clinically grounded, documentation-disciplined, and comfortable working in a compliance-driven Medicaid behavioral health environment.
This is a full-time, exempt, hybrid role based in Annapolis, Maryland, with office, virtual, and community-based work as assigned.
Key responsibilities
Own assigned admissions and assessment workflows from referral acceptance through completed admission handoff.
Review referral information for completeness, eligibility indicators, missing documentation, diagnosis/referral documentation, provider information, risk factors, and admission-readiness concerns.
Initiate contact with new referrals or referral sources within 1 business day of assignment.
Initiate intake scheduling within 2 business hours of referral acceptance and offer the earliest appropriate appointment no later than the next business day when client availability and referral readiness allow.
Complete PRP intake and assessment documentation in Alleva within credentialed scope and in accordance with Advocate policy, COMAR requirements, and Maryland Medicaid / Public Behavioral Health System expectations.
Administer the DLA-20 assessment as part of the PRP intake and assessment process in accordance with Advocate protocols.
Develop the initial Individual Rehabilitation Plan based on assessment findings, client-identified goals, medical necessity, PRP eligibility, and person-centered rehabilitation needs.
Verify or coordinate verification of payer/insurance requirements, Maryland Medicaid EVS status, diagnosis/referral documentation, referring/treating provider NPI, and authorization requirements for new admissions in coordination with Advocate's admissions, QA, authorizations, and operational support workflows.
Complete required admission-readiness and safety screening as assigned, including Maryland Judiciary Case Search and Maryland Sex Offender Registry checks when required by Advocate policy, and escalate concerns to leadership rather than making automatic admission-denial decisions.
Benefits
Vehicle Allowance
Admissions Incentive Program
Standard Full-time Employee Benefits
Prepare, submit, and track initial insurance/payer authorization requests for new PRP admissions using Carelon, Maryland Medicaid, or other designated payer portals where authorization is required.
Respond to payer requests for additional information and escalate denials, eligibility concerns, medical necessity concerns, delayed determinations, or authorization barriers promptly.
Complete assessment documentation and the initial IRP in Alleva on the same day as the intake/assessment appointment whenever operationally and clinically feasible, and no later than applicable Advocate, COMAR, Medicaid, or payer requirements.
Coordinate a clean admission handoff to PRP Operations, including assessment findings, initial IRP, insurance/EVS status, diagnosis/referral and provider/NPI verification status, initial authorization status, risk flags, engagement barriers, safety-screening concerns, and recommended next steps.
Update referral, authorization, and admission status in HubSpot, Alleva, payer portals, and other designated organizational systems on the same business day as meaningful activity.
Maintain audit-ready documentation that supports medical necessity, PRP eligibility, insurance/EVS verification, provider/NPI verification, required safety-screening completion, initial authorization readiness, Medicaid billing integrity, and continuity of care.
Required qualifications
Current CPRP (Certified Psychiatric Rehabilitation Practitioner), LMHP (Licensed Mental Health Professional), or both.
DLA-20 certification required; if not certified at hire, must obtain DLA-20 certification within the first 30 days of employment.
Experience completing behavioral health intakes, PRP assessments, psychosocial assessments, rehabilitation planning, or comparable documentation.
Ability to complete person-centered, audit-ready assessment and initial IRP documentation.
Ability to communicate professionally with clients, families, referral sources, treating providers, and internal team members.
Ability to manage sensitive information in accordance with HIPAA, 42 CFR Part 2 where applicable, and Advocate confidentiality standards.
Ability to use required Advocate systems, including Alleva, HubSpot, Microsoft Outlook, Microsoft Teams, SharePoint, ADP Employee Self-Service, and payer portals as assigned.
Ability to verify or coordinate verification of insurance/Medicaid eligibility, EVS status, diagnosis/referral documentation, referring/treating provider NPI, required safety-screening items, and initial authorization requests using designated systems and Advocate workflows after required training.
Ability to meet Advocate background check, drug screening, employment verification, and training requirements.
Valid Maryland driver’s license and reliable personal transportation required if community-based assessment activity is assigned.
Preferred Qualifications
Both CPRP and LMHP credentials.
Master’s degree in psychology, social work, counseling, rehabilitation counseling, psychiatric rehabilitation, human services, or a related field.
Experience in a Maryland PRP, outpatient mental health, Medicaid-funded behavioral health, case management, or community-based services setting.
Experience developing Individual Rehabilitation Plans or comparable person-centered service plans.
Familiarity with Maryland Medicaid / Public Behavioral Health System referral, EVS eligibility verification, provider/NPI verification, authorization, medical necessity, and PRP documentation workflows.
Experience verifying insurance/Medicaid eligibility, EVS status, diagnosis/referral documentation, provider/NPI information, and submitting or tracking initial insurance/payer authorization requests through Carelon, Maryland Medicaid, or similar payer portals.
Experience with Alleva, HubSpot, Microsoft Teams, SharePoint, Relias / Alleva InCheck, ADP, or similar systems.
Compensation and benefits
Salary Range
$70,000–$78,000 annually, based on credentials and relevant PRP/admissions experience.
Additional compensation
Eligible for Advocate’s admissions incentive program after established baseline admission expectations are met, subject to documentation quality, compliance, and leadership approval.
Vehicle allowance
Eligible for a $300/month vehicle allowance if community-based assessment activity is assigned and authorized in writing.
Benefits
Eligible for Advocate’s standard full-time employee benefits, subject to plan terms and eligibility requirements. HR should verify the exact benefits categories before posting.
Equal employment opportunity
Advocate Support Services, Inc. is an equal opportunity employer. Advocate provides reasonable accommodations to qualified individuals with disabilities in accordance with applicable law.
