Administration - 1345 River Bend Drive Suite 200 - Dallas, TX
Position Type
Full Time
Education Level
Masters
Travel Percentage
Travel within DFW Metroplex
Job Category
Management
Description
Are you looking for a purpose-driven career? At Metrocare, we serve our neighbors with developmental or mental health challenges by helping them find lives that are meaningful and satisfying.
Metrocare is the largest provider of mental health services in North Texas, serving over 55,000 adults and children annually. For over 50 years, Metrocare has provided a broad array of services to people with mental health challenges and developmental disabilities. In addition to behavioral health care, Metrocare provides primary care centers for adults and children, services for veterans and their families, accessible pharmacies, housing, and supportive social services. Alongside clinical care, researchers and teachers from Metrocare’s Altshuler Center for Education & Research are advancing mental health beyond Dallas County while providing critical workforce to the state.
The Service Provider Manager is responsible for overseeing and coordinating the Centers quality improvement and utilization activities. The position plans and coordinates program activities to ensure compliance with state, federal and contractual requirements. Other activities include monitoring various functions within provider services to guarantee timely compliance with assigned tasks, goals, and objectives of the Center.
Essential Duties And Responsibilities
The essential functions listed here are representative of those that must be met to successfully perform the job.
To implement an effective quality management program to ensure that individuals are receiving the most appropriate level of care, in the least restrictive setting, with properly trained clinicians/staff to provide quality services to individuals with developmental disabilities and/or mental illness.
To monitor the provision of services by internal and external providers of Metrocare Services for adherence to established policies and procedures of the Center.
To serve as a liaison for collaborative efforts between Metrocares internal providers, external agencies/providers, state agencies and the Behavioral Health Organizations (BHO).
Develops and implements a formal Quality/Utilization Management Plans and Program distinctive to the Healthcare Delivery System of Metrocare Services.
Develops and implements written operational procedures and revises as changes are made within the system.
Monitors the healthcare delivery system and related services to ensure the appropriately credentialed personnel deliver them within the appropriate continuum of care.
Serves as consultant to Internal Administrative Departments concerning what is required for external agencies and the monetary impact of service delivery.
Serves as a liaison for the agency internal provider network and oversees that appropriate established processes are adhered with admissions, discharges, and/or transfers.
Serves as an advocate for the agency to external providers for medically necessary services outside of Metrocare and works to see that these services are delivered.
Adheres to all state and federal regulations regarding confidentiality of service recipients identifying information for QM/UM purposes.
Collects, reviews, monitors, analyzes QM and UR data to the appropriate entities.
Provides education and training to the employees of Metrocare on QM policies and procedures and updates the training in a timeframe specified by the agency.
Responsible for interviewing and selecting new personnel for department and provides orientation and training for the employee once hired.
Responsible for adherence to any state and federal regulations for the agency, as well as, established guidelines of the state and BHO.
Assists with the effort to obtain external accreditation for the Center
Maintains regular communication with supervisor and attends scheduled management meetings for the efficient and successful operation of the department.
Performs other duties as assigned.
Competencies
The competencies listed here are representative of those that must be met to successfully perform the essential functions of
Conducts job responsibilities in accordance with the ethical standards of conduct, state contract, appropriate professional standards, and applicable state/federal laws
Analytical skills, professional acumen, business ethics, thorough understanding of continuous improvement processes, problem solving, respect for confidentiality, and excellent communication skills.
Extensive knowledge of state and local regulations and services
Knowledge of quality assurance and management, utilization management/utilization review processes
Statistical and analytical skills
People oriented skills and ability to work collaboratively in a team setting when indicated
Leadership skills
Excellent organizational skills
Implementation of processes and evaluation for effectiveness
Effective verbal and written communication skills
Qualifications
EDUCATION AND EXPERIENCE:
Masters Degree required and is an LPHA.
Minimum 5 years of progressively responsible administrative experience in a health care delivery system. At least three years of this experience shall be comprised of delivery of mental health and/or intellectual and developmental disability services. Professional experience in program management, auditing, and development of program guidelines, policies, and procedures.
LCSW, LMFT, or LPC required and CPHQ Certification Preferred
Mathematical Skills
Basic math skills required.
Reasoning Ability
Ability to apply common sense understanding to carry out simple one or two-step instructions. Ability to deal with standardized situations with only occasional or no variables.
Able to develop and implement policies and procedures
Ability to organize and facilitate meetings.
Able to effectively review and analyze quality improvement and utilization review data and submit such data in a timely manner.
Demonstrated experience in establishing rapport with health care professionals and health care administration.
Able to assist agency in contract compliance and meeting Medicare and Medicaid standards in areas that affect utilization of services.
Able to work autonomously.
Ability to make sound judgments
Computer Skills
Use computer, printer, and software programs necessary to the position (i.e., Word, Excel, Outlook, and PowerPoint).
Ability to utilize Internet for resources.
Benefits
Metrocare couldn’t have a great employee-first culture without great benefits. That’s why we offer a competitive salary, exceptional training, and an outstanding benefits package:
Medical/Dental/Vision
Paid Leave
Paid Holidays
Employee Assistance Program
Retirement Plan, including employer matching
Health Savings Account, including employer matching
Professional Development Allowance up to $1500 per year
Tobacco-Free Facilities - Metrocare is committed to promoting the health, well-being, and safety of Metrocare team members, guests, and individuals and families we serves while on the facility campuses. Therefore, Metrocare facilities and grounds are tobacco-free.
No Recruitment Agencies Please
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Sales and Business Development
Industries
Hospitals and Health Care
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