Clinical Supervisor / 142

Job Status: Full Time, Employee Job Category: Medical/Health Career Level: Manager (Manager/Supervisor of Staff) Reference Code: 142 Visit us on the web http://apshealthcare.com/ APS was founded as a behavioral healthcare company and has evolved into a specialty healthcare company that offers customized, integrated healthcare solutions across two major product lines: care management and behavioral healthcare services. The company has capitalized on its experience in behavior change to create physical and mental healthcare programs that are industry renowned. The use of an integrated approach to healthcare for the mind and body has allowed APS to be more effective in improving the quality and effectiveness of care. Today, APS is a pioneer in providing health and disease management services while retaining its position as one of the leading behavioral healthcare organizations in the United States. In fact, APS is the only specialty healthcare company with extensive experience in health management, behavioral healthcare, employee assistance programs (EAP), informatics and quality review/oversight programs. Clinical Supervisor / 142 Position Description:REPORTS TO: Clinical Director POSITION RESPONSIBILITIES:Oversee the day to day clinical operations of Behavioral Care Connection, which includes all utilization and case management activities. This individual has both clinical and operational responsibility for Case Management services. This person will assist with all regulatory and legal compliance, certification, and licensure issues. APS Healthcare employees are expected to maintain a positive work atmosphere through communicating and behaving in a manner that is courteous and respectful of customers, clients, co-workers, and supervisors.ESSENTIAL JOB FUNCTIONS:1. Provides supervisory oversight of the clinical department staff, including case management personnel. Provides clinical consultation as needed, and involves the Executive, Medical and Clinical Director when necessary.2. Works with Quality Improvement Manager to ensure the department meets NCQA and URAC standards, and works to continually improve the delivery of services to APS customers.3. Oversees management of department data including writing, processing, formatting, and troubleshooting of technical problems regarding departmental reports. Manages workload and staff to ensure goals met.4. In conjunction with the Clinical Director, develops and implements policies and procedures to operate the Case Management department with production expectations that are based on timelines, measurable output and customer satisfaction.5. Maintains thorough working knowledge of all customer products and data management systems (e.g., CCMS, CareConnection). 6. Maintains thorough working knowledge of all clinical review sets (e.g., HMS, ASAM). 7. Maintains thorough working knowledge of NCQA and URAC UM and CM Standards. 8. Monitors and reports on compliance with established department Policies and Procedures (e.g., URAC Standards, Clinical Q&A, audits, CQI, and NCQA requirements). 9. Coordinates department personnel, including training, staff development, daily schedules, and performance reviews in conjunction with APS Healthcare policies and procedures. Develop and maintain department training including orientation of new staff including development and maintenance of desktop policies and procedures, monthly in-services and other training as appropriate. 10. Participates as an active member on teams, committees, and other organization needs as identified and assigned.11. Assists with utilization review and case management cases as needed to maintain a smooth workflow within the department. 12. Maintains a log of success stories for use with customers.13. Provides services within the scope of practice defined by current education, certification or licensure, community and published standards.Must be able to travel to other office locations on a regular basis.Qualifications: Bachelors (or higher) degree in a health-related field and licensure as a health professional: orProfessional certification in a clinical specialty and at least five years experience as a care managerCertification(s) Required: Professional Hawaii state licensure, eligibility for Certification as a Care Manager. Minimum Experience: Minimum of 5 year’s direct clinical experience in acute care setting, managed care and/or utilization review experience preferred. Demonstrated supervisory experience andcritical thinking skill.Other Qualifications: Excellent oral, writing, and organization skills. Prior supervisory experience preferred. Ability to utilize word processing, spreadsheet, and database software to enhance data collection, information analysis and report writing. The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as classified.