Job Description

Monitors contractual compliance, provides administrative oversight and clinical consultation to assigned clinical team members.

PROCESSING DUTIES

  • Maintains and updates billing summaries for each assigned clinical staff member.
  • Reviews case loads to ensure clinicians are maintaining an adequate case load.
  • Reviews clinical documentation.
  • Ensures clinicians keep up to date with contractual deadlines and documentation requirements.
  • Ensures all documentation is completed for transferring and discharged clients.
  • Maintains contact with managed care agencies and other providers to resolve administrative and clinical issues.
  • Participates in peer reviews, case staffing, and department meetings as scheduled.
  • Participates in all staff meetings (biweekly, supervisors, and monthly in-service training.
  • Completes performance reviews on assigned team members
  • Reviews Prior Authorizations.
  • Responds to emergency calls and attends multidisciplinary meetings as required.

OTHER DEPARTMENT DUTIES AS ASSIGNED

  • Attends and participates in staff development training and workshops.
  • Enter data as required in the database system.
  • Generate correspondence as required.
  • Other department duties as assigned.

COMPETENCIES

TECHNOLOGY

  • Proficient with Word Processing Software Applications such as Excel and Word. Familiar with web search engines, e-mail applications -Outlook

LEADERSHIP SKILLS

Communication:

  • Expresses oneself effectively both orally and in written form
  • Communicates in a manner that supports strategies for staff involvement
  • Actively listens to others
  • Skillfully settles differences by using win-win approach
  • Disseminates information effectively among independent contractors.
  • Reports to immediate supervisor issues that may impact the Program.
  • Teamwork:
  • Uses appropriate interpersonal style to steer team members towards the goal.
  • Organizes resources to accomplish tasks efficiently
  • Reinforces change by embracing it.
  • Takes charge when the situation demands it.
  • Promotes a productive culture by valuing individuals and their contributions
  • Networks with peers and associates to build support base
  • Flexibility
  • Adapts to stressful situations
  • Willingness to change in order to meet organizational needs
  • Professionalism
  • Sets an example (role model)
  • Stays current in terms of professional development
  • Contributes to and promotes the development of the profession through active participation in the community
  • Reacts positively to key developments in area of expertise that may affect the Center.
  • Contributes ideas/solutions for process improvement.
  • Attends work consistently and on time.

DOCUMENTING AND RECORDING

  • Entering, recording, storing or maintaining information in written or electronic format abiding by program, agency, and contractual requirements.

WORKING CONDITIONS

  • Administrative Position requiring sitting, walking, light lifting, and bending.

Skills / Requirements

Licensed Mental Health Counselor, Licensed Marriage Family Therapist or Licensed Clinical Social Worker with minimum of 5 years of experience in Medicaid Services and Child Welfare.

  • LCSW Preferred.
  • Qualified CSW, HMC, MFT Supervisor Preferred.

Bilingual Preferred. 

Important Notes

Licensed Clinical Social Worker or Licensed Mental Health Counselor with a minimum of 5 years of experience in Medicaid Services and Child Welfare.

LCSW Preferred.

Qualified Supervisor MHC or Qualified Supervisor CSW Preferred. 

Bilingual Preferred.