Clinical Program Lead, BHCP

University of Massachusetts Medical School; Westborough (MA); On-site; USD 90,000 - 130,000; Full time

Job summary

University of Massachusetts Medical School seeks a skilled health services leader to provide clinical direction and supervise the care coordination team serving BHCP participants statewide.

You will oversee evaluation, regulatory compliance, staff training, and performance improvement initiatives, while maintaining HIPAA compliance and collaborating with state agencies and providers across Massachusetts.

Qualifications

• - Bachelor's degree in social work or nursing, OR Master's degree in mental health counseling.
• - Current Massachusetts licensure as a Licensed Social Worker, Registered Nurse, or Licensed Mental Health Counselor.
• - Minimum of 5 years of work experience providing direct service or case management to adults with mental health and behavioral health inclusive of 1 year of experience in a medical or clinical setting with knowledge of medical terminology.
• - At least 2 years of recent supervisory or management experience in a clinical setting.
• - Of the above experience, 2-3 years in care coordination or case management.
• - Demonstrated knowledge and experience with relevant social service/rehabilitation systems.
• - Knowledge of applicable state and federal regulations.
• - Proficient in the use of Microsoft Applications, including Word, Outlook and database.
• - Ability to travel statewide with a valid drivers license.

Responsibilities

• Provide clinical direction, supervision, and support to the care coordinator team providing care coordination services to BHCP participants.
• Provide in-person supervision of assigned care coordinator staff at nursing facilities biannually and as needed.
• Supervise the evaluation and assessment of care coordination services consistent with established procedural standards and ISA requirements to ensure eligible nursing facility residents have access to all recommended PASRR services.
• Assist Care Coordinators with case assignment, review, and finalization processes.
• Collaborate with other applicable State Agencies regarding identified issues of various populations.
• Research regulations and interpret these regulations for providers, agencies and staff.
• Provide clinical support to the program, and work with the program monitor and trainer to design and present training sessions for in-house staff or community-based providers as necessary.
• Review and propose changes to applicable program regulations, policies, and other documents.
• Coordinate contacts with providers to respond to inquiries pertaining to specific program areas.
• Oversee data integrity measures by reviewing and documenting all relevant information into data system applications in accordance with program guidelines and regulations.
• Conduct routine and ad-hoc evaluations and re-evaluations of individuals services.
• Support staff in contacting providers, state agency offices, and applicants/individuals to obtain information and records needed to conduct a comprehensive review of the case.
• Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long term care facilities and other programs/organizations involved in the provision of services.
• Participate in public relations efforts, attending conferences and meetings as needed.
• Maintain positive working relationships with participants and relevant informal supports, provider organizations, program consultants and state agencies.
• Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations.
• Foster team environment, and provide professional and clinical leadership to team members, including consultants, providers and administrative support staff as appropriate.
• Direct team members in identifying and addressing issues involving clinical matters.
• Communicate policy, workflow and organizational changes to team members.
• Provide orientation and ongoing in-service/continuing education programs for team members.
• Conduct performance evaluations of team members.
• Participate in the hiring and termination of team members.
• Work closely with Associate Director and other management staff to ensure clinical integrity is maintained in the PASRR and BHCP process.
• In collaboration with the Director and other management staff, coordinate performance improvement and quality assurance activities.
• Prepare written reports as requested.
• Travel to and from providers places of business and state agency offices.
• Support the preparation of and responses to requests for statistics and resource/service data.
• Participate in performance improvement initiatives and demonstrate the use of quality improvement in daily operations.
• Comply with established departmental policies, procedures and objectives.
• Comply with all health, safety and program regulations and requirements.
• Perform other related duties as required or directed.

Skills

Travel readiness

Education

Bachelor's degree in social work or nursing

Master's degree in mental health counseling

Licensed Social Worker (MA)

Registered Nurse (MA)

Licensed Mental Health Counselor (MA)

Tools

Microsoft Word

Microsoft Outlook

Database management

Job description

University of Massachusetts Medical School seeks a skilled health services leader to provide clinical direction and supervise the care coordination team serving BHCP participants statewide.

You will oversee evaluation, regulatory compliance, staff training, and performance improvement initiatives, while maintaining HIPAA compliance and collaborating with state agencies and providers across Massachusetts.