Clinical Utilization Manager
JOB SUMMARY: The Therapeutic Services Clinical Utilization Manager is responsible for authorizing services for Department of Health and Human Services (DHHS) neglect and abuse cases in which a Jurist (Judge or Referee) of the Third Judicial Court or DHS/CPN worker requests services and interventions to assist the caretakers or family members to resolve issues that put the child(ren) at risk of removal from the home. Services are authorized through the AFS Therapeutic Services specialized, Provider Network Agencies (PNAs); technical assistance is provided to the PNAs through meetings and trainings. Duties also include authorizing, monitoring and managing service request(s) to assure that services are conducted in a timely manner with appropriately documented clinical service interventions which could result in effective and satisfactory outcomes, allowing the children to be reunited with their family.
- Effectively demonstrates working knowledge of the Juvenile Justice/Child Welfare System.
- Demonstrates punctuality on a regular basis, with minimal tardiness and absences without previously informing the supervisor.
- Able to view & analyze problems objectively and resolve them in a timely manner.
- Ability to work methodically, with attention to detail, to assure accuracy and meet prescribed timelines.
- Familiar with the case log-in and authorization process to assure that services are approved in a timely manner.
- Familiarity of the psychological/psychiatric authorization and completion process.
- Familiar with the case copying process and knowledge of what documents are sent to the provider network agencies.
- Ensures that requests for case files are handled promptly and efficiently in the absence of the clerk.
- Ensures that all loose paperwork is consistently placed in the “to be filed” tray and that all other paperwork is filed in a timely manner.
- Assists with filing historical audit report findings.
- Answers and screens telephone calls, giving routine and accurate information to Jurist, DHHS/CPN agency workers or providers as needed.
- roficient in the Juvenile Agency Information System (JAIS) to document service requests and collateral contacts.
- Coordinates with the Utilization Review Clerk, if applicable, to maintain a closed/terminated case file system.
not yet approved, or rejected accordingly.
- Accurately reviews Billable Status Reports (BSR) and adheres to qualitative and quantitative requirements.
- Utilizes supervision with AFS consultant or supervisor to address clinical concerns and submits technical assistance recommendations to Provider Network Agencies to improve documentation and approval percentages on Billable Status Reports (BSRs).
- Accurately monitor units of services rendered to clients, to assure that the clinicians providing services have been properly credentialed through the AFS TS Department.
- Effectively coordinates, conducts and facilitates group supervision, technical assistance, and trainings with Provider Network Agencies.
- Consistently attends/conducts trainings or meetings for providers or referring workers, as requested.
- Assists with preparing agendas for meetings, and takes minutes of meetings held in the office and/or other locations.
- Facilitates contact with referred person and referring worker to ascertain satisfaction surveys and outcome data for authorized services by AFS, as well as clinical services performed by Provider Network Agency and AFS staff.
- Coordinates the implementation and training of all contracted providers, by working closely with provider supervisors and clinicians to ensure understanding of contractual responsibilities.
- Monitors and evaluates activities/services of Provider Network Agencies to ensure that services are conducted according to established standards and contracted agreements; recommends contract re-negotiations or termination schedules.
- Accurately reviews early terminated/completed services from Provider Network Agencies and enters status in JAIS.
- Consistently completes Additional Unit Requests to assure provider utilization review of required documents on JAIS, and provides follow-up recommendations to provider in a timely manner.
- Consistently attends case consults to discuss client progress and need for more services.
- Proficient in the use of Odyssey to verify the status of a referred person’s legal status and disposition.
- Conduct regular Provider Network Agency audits according to the established schedule and/or as provider performance requires and promptly completes related paperwork according to departmental requirements.
- Capable of developing audit timeframes, goals and objectives, prioritizing areas for audits based on maximization of resources and organizational importance.
- Accurately and promptly prepares audit report findings to be used by Provider Network Agencies to validate compliance and indicate when additional concern or follow-up may be required.
- Reviews and investigates all Unusual Incident Reports as submitted by the Provider Agencies; to include request for additional information prior to logging and submission to the AFS QA Department.
- Completes all tasks and duties as assigned by TS Supervisor, or CEO/COO.
QUALIFICATIONS: Master’s level clinician (Social Work, Counseling, Psychology). 3-5 years of experience working in the social service field. Extensive experience in service coordination and understanding of treatment modalities for clients with clinical issues of substance abuse, adult and child mental health and family services coordination required. Ability to work rapidly with a high degree of precision to ensure accuracy and meet prescribed timelines. Thorough understanding of clinical utilization management and billing with actual experience preferred.
JOB SUMMARY: Under the direction of the Supervisor, assesses family needs; develops and implements individualized treatment plans; implements interventions that facilitate youth and family progress toward specific goals and objectives; participates in multi-disciplinary case staffing and utilizes caseload management systems; conducts individual, family and group counseling sessions in accordance with professional standards; collaborates with appropriate agencies and parties within the community and the Wayne County Juvenile Justice system; and performs other duties as assigned.
- Conducts individual, family, and group therapy sessions according to individualized treatment plans and in accordance with professional standards and empirically supported treatments.
- Interviews, assesses, and identifies mental health or other problems using approved assessment instruments, social history, and consultation with community and Juvenile Justice resources.
- Prepares reports as requested.
- Makes treatment recommendations to appropriate agencies in order to affect a positive impact on the individual’s performance and collaborates with the Juvenile Justice Case Manager relating to other related referrals needed.
- Creates, maintains, and submits accurate records and documents on a timely basis and in an appropriate manner.
- Prepares weekly statistical service reports to assist in monitoring services rendered and billing.
- Collaborates and interacts with other Juvenile Justice workers for feedback regarding client treatment attendance and overall progress toward goals.
- Maintains current knowledge of assessment and treatment techniques, criminal justice systems and community resources using in-service trainings, seminars, workshops, and publications, maintaining the minimum necessary for credentialing requirements.
- Effectively demonstrates working knowledge of the Juvenile Justice System.
- Generates at least 5 direct service hours per day or an average of 25 hours per week.
- Actively participates in team meetings and trainings.
- Maintains appropriate department, agency, and client confidentiality.
- Engages in crisis intervention as necessary.
- Follows safety protocol and procedures.
- Prepares for and actively engages in weekly supervision.
- Provides services primarily in the home and attempts to engage youth and family.
- Other duties as assigned.
- Demonstrates punctuality on a regular basis, with minimal tardiness and absences without previously informing the supervisor.
Qualifications: Master’s level counselor/social worker. Experience providing individual/family/group therapy to diverse populations required. Previous experience with juvenile justice youth preferred. Adequate transportation for frequent home visits is a must along with valid driver’s license and auto-insurance. Proof of licensure within defined field of practice. Strong computer skills. Effective communication skills both written and verbal.
SUBSTANCE ABUSE THERAPIST
Qualifications: We are seeking a licensed Master’s level counselor, social worker or psychologist with experience providing individual/family/group therapy to diverse populations. This position requires substance abuse credentials. Previous experience with Juvenile Justice involved youth preferred. Adequate transportation for frequent home visits is a must, along with valid driver’s license and auto-insurance.
The candidate must be able to meet the Michigan Department of Community Health qualifications as a Child Mental Health Professional (CMHP) (An individual with specialized training and one year of experience in the examination, evaluation, and treatment of minors and their families and who is a physician, psychologist, licensed or limited-licensed master’s social worker, licensed or limited-licensed professional counselor, or registered nurse; or an individual with at least a bachelor’s degree in a mental health-related field from an accredited school who is trained and has three years supervised experience in the examination, evaluation, and treatment of minors and their families; or an individual with at least a master’s degree in a mental health-related field from an accredited school who is trained and has one year of experience in the examination, evaluation and treatment of minors and their families.)
Proof of licensure within defined discipline is necessary. Strong computer skills, effective communication, both written and verbal, is mandatory, along with the ability to demonstrate a high value for accountability, accuracy and reliability is required.
Integrated Community Based Services Coordinator
JOB SUMMARY: Strong bachelor or masters level clinician that under the direction of the ICBS Supervisor, provides clinical consultation, support and guidance regarding the access to and participation in behavioral health services of Wayne County juvenile justice CMO SED and DD youth and family needs; timely submission of individualized treatment plans; collaborative relationships with care management providers, implements direction and monitoring that facilitates youth remaining safely in the community and benefiting from therapeutic supports and treatment toward specific goals and objectives; facilitates multi-disciplinary case staffing and;;, timely documentation, reporting and documents the service provision in JAIS, monitors and assures follow up by CMH Children’s Service agencies and performs other duties as assigned. 4 days per week in the juvenile care management agency, 1 day in office for supervision and documentation requirements.
JOB SPECIFIC RESPONSIBILITIES:
- Collaborate and interact with other AFS and CMO Juvenile Justice workers for feedback regarding client treatment attendance and overall progress toward goals.
- Maintain current knowledge of behavioral health and consultation for treatment techniques, criminal justice systems and community resources using in-service trainings, seminars, workshops, and publications, maintaining the minimum necessary for credentialing requirements.
- Effectively demonstrate working knowledge of the Juvenile Justice System and Detroit Wayne Community Mental Health resources and services.
- Has a strong ability to communicate and advise youth behavioral health needs with CMO worker, CMH therapists and to explain, encourage and facilitate the needs of the client and family effectively and efficiently.
- Has an understanding of juvenile youth ready to exit residential care to assure family stability, access to continuity of treatment and timely service provision.
- Convening Integrated team quarterly and /or at transitions.
- Support the juvenile justice CMO and youth and family to receive appropriate and timely services to better assure the youth remains stable and benefit from community supports. Ensuring the EPSDT, medical, physical and behavioral health docuementation is completed and in the file for every Medicaid eligible SED and DD youth.
- Actively participates in team meetings and trainings.
- Maintain appropriate department, agency, and client confidentiality.
- Ability to engage in crisis intervention as necessary to assure appropriate treatment engagement and provision.
- Follow safety protocol and procedures.
- Prepare for and actively engages in weekly supervision.
QUALIFICATIONS: BA or BSW or MA/MSW or related degree in mental health from an accredited school and appropriate State of Michigan licensure required. Must have a minimum of five (5) years recent experience in mental health/human services field.
Familiarity with Medicaid policies and procedures and a general knowledge of least two (2) of the following systems: Detroit-Wayne County Community Mental Health Agency, Michigan Department of Human Services, Wayne County Department of Children and Family Services (juvenile justice), and the Wayne County Juvenile Court system will be important.
Must have knowledge of Systems of Care philosophy and principals. Must be a skilled observer and communicator with understanding Mental health service systems.
CHIEF OPERATING OFFICER
JOB SUMMARY: The Chief Operating Officer plans, develops, organizes, directs and oversees the daily operations of AFS Partnership to contribute to meeting the mission and goals of the partnering organizations, as well as the requirements of contract, applicable federal, state and local regulatory and/or accrediting agencies.
- Effectively demonstrates working knowledge of the Juvenile Justice, Child Welfare and Community Mental Health Systems.
- Demonstrates operational excellence within AFS, to ensure quality registration, enrollment processes, assessment services, service track monitoring and review, and outcome measurement in accordance with policies and procedures.
- Consistently provides fair interpretations and enforcements of HR polices, offering clarification as required, for assigned departments.
- Coordinates and reviews the maintenance of effective and appropriate staffing as evidenced by ongoing budgetary analysis, for assigned departments.
- Reviews and promptly acts upon all senior management performance appraisals, consistent with Human Resource policy, for assigned departments.
- Ensures that all managers are conducting employee disciplinary procedures with appropriate documentation according to Human Resource policy and employee relation laws and guidelines, for assigned departments.
- Coordinates the selection of qualified employees for employment according to Human Resource policy and employee relation law and guidelines, reviewing such clarifications with employees, for assigned departments.
- Consistently reviews employee turnover, overtime and absenteeism for cost centers, for assigned departments, and provides justification as requested by the CEO.
- Coordinates and reviews the implementation of participative management through employee input in creative problem-solving teams, suggestions, task forces, committees, and other forms of feedback according to organizational philosophy, for assigned departments.
- Coordinates the development, promotion and implementation of services and programs
- Consistently serves as a role model for all employees by adherence to, and positive attitude towards, all policies, programs and activities.
- Provides technical assistance to employees and providers to improve the quality of service delivery.
- Acts as a liaison with assigned departments to ensure their strategic/action plans are completed.
- Demonstrates the ability to plan work and complete tasks with minimal direction, and provides/receives constructive recommendations as needed.
- Demonstrates the ability to implement problem-solving mechanisms in both routine and emergency situations; bases decisions on fact rather than emotion.
- Demonstrates the ability to identify and resolve interpersonal or professional conflicts when dealing with members of the organization.
- Consistently holds regularly scheduled staff meetings and provides minutes to staff as established by policy.
- Consistently and efficiently seeks out, understands, listens and conveys information in a clear manner, as necessary, in both written and verbal forms.
- Investigates and promptly responds appropriately to all complaints and takes effective corrective action when necessary, in accordance with policies and procedures.
- Broadens knowledge in the field of assessment, treatment, juvenile services and/or quality management through attendance and training offered in the community.
- Provides supervision with individual Senior Management and core staff to review performance and program-specific responsibilities.
- Coordinates with Community AFS, Court AFS and JDF AFS staff to prepare a plan for incoming clients and provides consultation regarding appropriate case assignments, processes, procedures and written policies.
- Demonstrates the ability to provide crisis intervention with clients and customers when needed.
- Maintains accurate documentation and appropriate records for all components of services, for assigned departments.
- Consistently coordinates with appropriate assigned department staff, to ensure uniformity of the QA presentation and process.
- Coordinates with the CEO regarding current quarterly contracting processes and issues.
- Coordinates with CEO to identify areas of service and clinical need, reviews issues raised through staff meetings, and establishes an agenda for services through administrative team meetings.
- Demonstrates administrative leadership; consistently takes initiative to provide feedback, suggestions and consultation to other service programs/staff in a proactive manner.
- Monitors the process of daily operations to ensure quality, and ensures client/customer sensitive treatment for all youth, families and referral sources.
- Assists in the development/monitoring budget for assigned departments; contributes to the financial stability of the agency through achievement of budgeted targets and expense goals.
- Consistently maintains expert, credentialed (assigned) departments, and other expert staff through department evaluation and hiring, for management positions of assigned departments.
- Consistently attends and participates in appropriate Management Training and Development workshops as scheduled by the agency.
- Consistently accepts and actively fulfills additional responsibilities as assigned by the CEO, with a positive attitude.
QUALIFICATIONS: Master’s degree or higher credential in a human services related field. Minimum of three years working in behavioral health, child welfare, juvenile justice including at least two years of administrative responsibility. Demonstrated grant writing experience. Demonstrated leadership skills and creativity in respective fields.
Ability to demonstrate a high value for accountability, accuracy and reliability are a must. Must have exemplary organizational skills with an acute attention to detail.
Strong and effective communication skills both written and verbally. Strong computer skills.