CLASS SUMMARY:
Position is responsible for the continued development, direction and management of the regions services designed to facilitate and promote appropriate access to community-based acute care services and supports for adults with serious mental illness, co-occurring disorders and crisis stabilization services. Position requires knowledge of services, programs and populations to be served, principles and practices applicable to behavioral health, knowledge of clinical issues pertaining to the need for acute care and crisis stabilization and of the behavioral healthcare delivery system in general. Major duties will include oversight, implementation and further analysis of the HPR V Reinvestment Services, and coordination of all project activities with CSB staff, Eastern State Hospital staff, the Department of Behavioral Health and Developmental Services, and all other community stakeholders. At the direction of the HPR V Systems Performance and Project Design Work Group, develop, implement and monitor all programming within Project including but not limited to: utilization management, hospital diversion programming, referral, involvement with community stakeholders, community education and liaison, provider network oversight and communications, as well as financial/budget program responsibility. This position will report to a regional group via the Chair of the Regional Council of Executive Directors.
DISTINGUISHING ELEMENTS OF THE CLASS:
I. IMPACT: The general health and welfare of consumers seeking access to the region's system of care are directly dependent on the work of this class. The incumbent is responsible for determining and responding to the needs of the consumer population. This class is directly accountable for ensuring efficient, effective and economically responsible programming operated by CSBs and contracted vendors in accordance with the project design of the HPR V Reinvestment Services. The incumbent facilitates referrals to other services and programs contractually related to this project as well as to other service/agencies based in Health Planning Region V. The HPR V CSB's public image, reputation, credibility and responsiveness are directly and profoundly impacted by the work of this class.
II. LATITUDE: Work is initiated by the incumbent in response to direction from the HPR V Regional Reinvestment Planning Leadership. Guidance is provided by the HPR V Reinvestment Implementation Plan, professional standards of the field, and governmental, state, federal and agency policies and procedures. The incumbent must exercise considerable independent judgment on frequent occasions.
III. RESPONSIBILITY FOR THE WORK OF OTHERS: Supervision is exercised over two (2) staff members: Utilization Management Coordinator and Data/Financial Analyst. Appointment and termination of staff members are recommended by the incumbent. Staff composition may increase as determined by the Regional Leadership Team.
IV. INTERPERSONAL CONTACTS: Work involves continuous and extensive representation of the HPR V Reinvestment Services and/or CSB interests to other agency officials, officials and staff of other local and state agencies and advisory boards, criminal justice agencies, service providers and consumer/family advocacy groups. The incumbent interfaces with a variety of others including: clinical staff of this and other agencies, court and law enforcement personnel, emergency room physicians, hospital personnel, managed care organization personnel and private practice providers.
V. DIFFICULTY: Work requires creative problem solving and management follow up. Considerations affecting policy and program decisions are dynamic, intricate and numerous. Negotiation of complex issues with a divergent group of participants representing differing interests, agenda and opinions involves the careful exercise of independent judgment and tact.
VI. COMMUNICATIONS: Work involves the development, preparation and presentation of detailed funding, utilization review, complex reports, management policies and procedures and other progress reports. Public speaking and representing the HPR V Reinvestment Services to the general public, community groups, advisory boards and consumer/family advocacy groups is required. Work involves the use of clear, consistent use of language in a professional, respectful, supportive and non-adversarial manner.
VII. EQUIPMENT/FACILITIES RESPONSIBILITY: Utilizes common office equipment in performing assigned duties. The incumbent frequently operates a vehicle.
VIII. WORKING CONDITIONS: The incumbent performs most work in a typical office environment, however due to the regional nature of the HPR V Reinvestment Services; the incumbent will be required to travel extensively throughout the southeastern region of Virginia, including the Eastern Shore.
IX. KNOWLEDGES, SKILLS AND ABILITIES (KSA'S):
Thorough knowledge of the services, programs, service providers and population characteristics to be served by the HPR V Reinvestment Services.
Thorough knowledge of management principles and practices applicable to behavioral health programs.
Excellent knowledge, skills and abilities in word processing; spreadsheets; and database systems.
Excellent skills in oral and written communication and generation of program reports, utilization reports, quality improvement reports and project updates.
Good knowledge of consumer management information systems including clinical record management and reimbursement billing functions.
Good knowledge, understanding and sensitivity to issues of persons affected by serious mental illness.
Good knowledge of the behavioral healthcare delivery system for the state.
Good skill and ability in relating to and coordinating with other health/human service agencies.
Ability to creatively develop solutions and strategies to resolve healthcare system issues/barriers for consumers.
Ability to effectively relate to persons with serious mental illness and their families.
Ability to work independently yet function effectively as a team member with multiple level of supervision and guidance.
Ability to set priorities and effectively manage time and projects.
Outstanding ability to communicate effectively with a wide variety of individuals including consumers, family members, staff, referral sources, and the general public.
X. LICENSURE: Valid state driver's license.
XI. PRINCIPAL DUTIES AND RESPONSIBILITIES OF CLASS (ILLUSTRATIVE ONLY):
Develop, monitor and evaluate the regions service delivery programs for the HPR V Reinvestment Services.
Coordinate the HPR V Reinvestment Services with the HPR V CSBs, Eastern State Hospital, and the DBHDS.
Acts as a liaison with other agencies providing services and the consumer and family groups.
In conjunction with the Financial Planning and Contract Management Workgroup, develops, administers and manages the HPR V Reinvestment Services budget.
Verifies vendor invoices and authorizes vendor payments.
Provides fiscal reporting, data driven reporting.
Develop and submit utilization, financial, outcome and evaluation reports as required.
Ensures all HPR V Reinvestment Services programming is in compliance with DBHDS licensure requirements and applicable regulatory standards.
Acts as a liaison and coordinates services among the HPR V CSBs to ensure maximum cooperation and communication.
In conjunction with the Human Resource Departments of the DBHDS, ESH and the HPR V CSBs, assists in the development and implementation of a workforce transition plan for all employees affected by the HPR V Reinvestment Services.
With System Performance and Clinical Design Workgroup, develops and implements quality assurance and utilization management protocols for all HPR V Reinvestment Services and programming.
As a member of the Systems Oversight and Project Design Workgroup, is responsible for planning and developing services to meet consumer needs.
Responsible for management of all HPR V Reinvestment Services treatment and community support services to ensure effective and efficient system of care.
In conjunction with the Systems Performance and Project Design Work Group, establishes goals, objectives, performance indicators, and QA/UM protocols for the HPR V Reinvestment Services.
Ensures compliance with all state, local and federal regulations as they relate to treatment, community support and third party reimbursement.
Ensures that quality standards are maintained by all staff involved in the HPR V Acute Care Reinvestment Project.
Accountability for all HPR V Reinvestment Services program budgets. Develops and monitors all regional program service budgets. Closely monitors Medicaid and other third party revenues generated and makes appropriate programmatic changes to increase revenues where possible.
Helps to develop alternative funding sources. Assists in the development of grant applications and ensures effective implementation of new grant programs.
In conjunction with the Medical Director assigned to the HPR V Reinvestment Services, facilitates implementation of clinical standards, training and compliance.
Represents the HPR V Reinvestment Services on various internal and external committees as needed or as assigned by the Regional Reinvestment Partnership.
In conjunction with the Systems Performance and Project Design Work Group, develops information technology resources and assistance necessary to maintain an up to date consumer information data base and information sharing system in compliance with HIPPA and other confidentiality regulations.
XII. PHYSICAL REQUIREMENTS: Must have the use of sensory skills in order to effectively communicate and interact with other employees and the public through the use of the telephone and personal contact as normally defined by the ability to see, read, talk, hear, handle or feel objects and controls. Physical capability to effectively use and operate various items of office related equipment, such as, but not limited to a, personal computer, calculator, copier, and fax machine. No significant walking, moving, carrying, climbing, bending, kneeling, crawling, reaching, and handling, sitting, standing, pushing, and pulling.
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