General Summary: Under the direction of the department Director, responsible for day-to-day supervision of the clinical operations department. Manages the delivery of quality care management, clinical utilization and referral services. Ensures consistent application of ValueOptions policies and criteria, and adherence to performance standards. Demonstrates excellent written and verbal communication skills. Collaborates with Director to ensure consistent communication within the department.
Essential Duties and Responsibilities:
Monitors day-to-day operations and evaluates the performance, productivity and documentation of assigned staff.
Review for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply BHO criteria and render certification decisions that are within the scope of practice that is relevant to the clinical areas under review.
Participates in staff recruitment and responsible for the orientation, supervision and performance appraisal of assigned clinical staff. Responsible for staff auditing and corrective action.
Identifies areas for quality improvement within department and implements QI activities.
Interfaces with internal and external customers in a prompt and professional manner to ensure optimal quality of service. Acts as a liaison with other operations departments.
Monitors departmental compliance with all performance standards, legal and regulatory requirements.
Maintains updated workflows based on current policies and procedures and supervises staff adherence to workflows
Assists Director of Clinical Operations with other duties as assigned.
Participates in and leads weekly staff meetings for assigned staff.
Participates in quality, regulatory, and account-specific meetings as assigned.
Maintains confidentiality, ethical and professional standards of all direct line and supervisory staff.
Responsible for departmental reporting oversight and management.
- Education: A minimum of a B.S. Degree in mental health field or an Associate’s Degree in Nursing with related psychiatric nursing experience.
Licenses: Current, valid and unrestricted license in a State or territory of the United States in a mental health field (RN, Ph.D., LCSW/LMSW, MHC, LPC, etc.). Relevant Work Experience: 5 years behavioral healthcare experience and 3 years managed care experience with a minimum of 1 year supervisory experience is preferred.