Under direction, monitors the delivery of Macomb County Community Mental Health (MCCMH) funded services to persons with mental illness, substance use and/or developmental disability to ensure quality and compliance to federal, state and local performance standards.
Essential Functions and Responsibilities As a member of executive staff, contributes to strategic planning and organizational development functions of MCCMH.
As a member of the Utilization Review Committee, contributes to the identification and measurement of limitations in the MCCMH system of care and establishes performance indicators for network providers.
Reviews providers' clinical documentation requirements. Reinforces implementation of clinical documentation formats and processes to comply with Medicaid and national accreditation requirements for directly operated service programs.
Coordinates between MCCMH behavioral health services and the Substance Use Disorder department to form a seamless system of care.
Coordinates activities necessary for the Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation and the National Committee for Quality Assurance (NCQA) process.
Manages the quality improvement program including the development of Quality Assessment and Performance Plan (QAPIP), Performance Improvement Plan (PIP), NCQA/CARF, and internal quality audits.
Provides technical assistance and consultation for policy development and maintenance of the Managed Care Organization (MCO) and administrative manuals.
Assists in department reviews of court decrees, attorney general opinions, the Michigan Department of Health and Human Services (MDDHS) policies, proposed legislation, and guidelines of regulatory bodies.
Develops and writes policies and procedures that establish standards of quality to provide guidance to management, medical staff, and employees.
Develops and maintains positive working relationships with community agencies, organizations and advocacy groups.
Provides guidance, direction, and feedback on employee performance.
Provides staff support for Macomb County Community Mental Health Quality Council.
Operates an automobile to perform assigned job functions.
Performs related duties as assigned.
Qualifications Required Education and Experience Master's Degree or Doctorate in Social Work, Counseling, Psychology, Nursing or a Doctorate in Psychology from an accredited college or university Five (5) years of experience in a health care setting overseeing quality Three (3) years of experience in staff supervision or management
Required Licenses or Certifications State licensure, certification, or registration for practice of the discipline of the degree Possession of a valid Michigan driver's license and operable, insured automobile for authorized travel
Competencies for Successful Performance of Job Duties Knowledge of: Michigan Mental Health Code rules and regulations Medical Services Administration (MSA), Medicaid Policies, and bulletins Prepaid Inpatient Health Plan (PIHP) and Community Mental Health Services Programs (CMHSP) contracts with Michigan Department of Health and Human Services (MDHHS) Applicable computer applications
Skill in: Using good professional judgment and initiative Excellent written and oral presentation skills Analyzing information and completing reports
Ability to: Collaborative: Approaches all situations with a teamwork and solution focused mindset demonstrated through active participation in meetings, volunteering to assist teammates and other departments as appropriate. Examples include participation in internal and external committees, subcommittees, process improvement groups or other multi-organizational initiatives Accountable: Takes ownership and empowers others to do the same as evidenced by identifying solutions and acting on job responsibilities and organizational objectives, daily Respectful: Treats people with dignity while honoring individual differences demonstrated through use of positive and encouraging statements and/or interactions to, about and/or with colleagues and persons served; evidenced by supervisor observation, feedback from other department staff and leadership Work in an environment which embraces the county's Dignity Campaign Effectively speak, write and understand the English language Effectively speak, write and understand a language other than English is preferred Understand and carry out oral and/or written instructions Accurately organize and maintain paper documents and electronic files Maintain the confidentiality of information and professional boundaries Work independently