Utilization Management Supervisor (PPM III)

King County, WA; Seattle (WA); On-site; USD 110,000 - 160,000; Full time

Job summary

King County Department of Community and Human Services is seeking a Hospital and Mental Health Residential Treatment Utilization Management Supervisor to lead a MH Care Authorizers team, ensuring the appropriate level of care and timely transitions for residents.

The role oversees program management, quality assurance, data reporting, and collaboration with BHRD and KCICN, with a focus on equity and high-quality care for individuals in high-intensity services.

Qualifications

• Master's degree with independent license in a relevant field.
• Knowledge of mental health residential treatment facilities and discharge planning.
• Experience leading operations, care-transition decisions, and cross-department collaboration.
• Experience with publicly funded behavioral health service systems.
• Excellent verbal and written communication skills.
• Ability to analyze data and generate reports for system improvements.
• Ability to manage multiple tasks and meet deadlines.
• Pass a criminal background check.

Responsibilities

• Lead a team of MH Care Authors to ensure appropriate level of care and progress in recovery.
• Participate as a key member of the BHRD Utilization Management Committee.
• Lead quality assurance activities including site visits, contract reviews, and invoice reconciliation.
• Drive quality improvement to optimize flow between levels of care and utilization management.
• Complete continuing stay reviews to determine medical necessity per LOCUS assessments.
• Supervise HMHR staff as part of the Utilization Management Team.
• Collect, analyze, and report utilization and care-transition data for timely progression of care.
• Coordinate with BHRD and other KC offices to maintain effective partnerships.
• Align workflows to promote equity and social justice in care transitions.
• Attend meetings and treat conferences; troubleshoot issues across providers and agencies.

Skills

Leadership

Data analysis

Communication

Collaboration

Project management

Public health systems knowledge

Education

Master's Degree in Social Work, Psychology, Behavioral Science, or related field with independent license

Tools

MS Outlook

MS Word

PowerPoint

Excel

Job description

Summary

King County's Department of Community and Human Services (DCHS) provides equitable opportunities for people to be healthy, happy, and connected to community.

At King County Department of Community and Human Services (DCHS), we believe in working as one team that solves problems—striving to be customer-focused and drive for the best results. We envision a welcoming community that is racially just. We believe the field of human services exists to undo and mitigate unfair structures. We seek to lead the way by working as respectful and responsible stewards for our community.

The Behavioral Health and Recovery Division (BHRD) of DCHS is seeking a Hospital and Mental Health Residential (HMHR) Treatment Utilization Management Supervisor (Project/Program Manager III). This position holds direct responsibility for the overall utilization management operations of the Hospital & Mental Health Residential Treatment Team.

The Supervisor will lead a team of Mental Health (MH) Care Authorizers responsible for ensuring that King County residents accessing MH residential care and other high-intensity MH programs receive the appropriate level of care, appropriate services, and the support needed to step down to lower levels of care as they progress in their recovery. This position will participate as a key member of the BHRD Utilization Management Committee and will lead quality assurance activities, including site visits, contract compliance reviews, invoice reconciliation, and other monitoring tasks as assigned.

Job Duties

To be considered minimally qualified applicant must demonstrate a background that provides the knowledge, skills and ability to:

• Lead a team of MH Care Authorizers tasked with ensuring that King County residents that are accessing MH Residential care and other high intensity MH programs are accessing the level of care that is needed, are receiving appropriate services, and are receiving additional support needed to step down to lower levels of care and progress in their recovery
• Participate as a key member of the BHRD Utilization Management Committee
• Lead quality assurance activities, including site visits of mental health residential treatment providers, contract compliance reviews, invoice reconciliation, and other monitoring activities as assigned.
• Lead quality improvement activities, focused on improving oversight of the delivery of high intensity mental health services, improving flow between levels of care, and improving efficiencies in utilization management/care coordination.
• Complete and direct continuing stay reviews to determine that an individual continues to meet medical necessity standards commensurate to the current level of functioning as determined by the Level of Care Utilization System (LOCUS) Assessment.
• Supervise and monitor team of Mental Health Utilization Project-Program Manager II staff as part of a collaborative Utilization Management Team.
• Lead the collection, analysis, and reporting of utilization and care-transition data to ensure timely progression of care, appropriate resource use, and optimal patient throughput across the continuum.
• Develop close coordination, partnership and communication within the Behavioral Health and Recovery Division (BHRD) and other Departments within the Department of Community & Human Services.
• Ensure continuing stay reviews meet Utilization Management Timelines established by BHRD’s Quality team and Managed Care Organizations (MCOs).
• Communicate outcomes of continuing stay reviews with supervisors of mental health residential facilities contracted through the King County Integrated Care Network (KCICN).
• Develop and maintain excellent working relationships with behavioral health providers working in the mental health residential treatment continuum.
• Align workflow of Utilization Management Team to promote equity and social justice, recovery-oriented system of care, with the goal to provide transition from psychiatric hospitalization.
• Attend and participate in assigned meetings, treatment conferences, and committees relevant to performance of job functions.
• Troubleshoot, advocate, and resolve issues that may arise between community members, behavioral health housing providers, or governmental organizations.
• Participate as part of Hospital and Mental Health Residential Treatment (HMHR) Section Leadership Team.
• Perform other related duties as assigned.

Experience, Qualifications, Knowledge, Skills

WE ARE LOOKING FOR CANDIDATES WHO HAVE:

• Master's Degree in Social Work, Psychology, Behavioral Science, or related field with independent license.
• Mental Health Professional as defined in WAC 246-341-0200 and RCW 71.05.020.
• Demonstrated leadership skills to include leading daily operations, supporting care-transition decision-making, and promoting collaboration across departments to optimize resource utilization and patient movement.
• Experience working with publicly funded behavioral health service systems.
• Knowledge of issues related to mental health residential treatment facilities.
• Knowledge of and experience with psychiatric hospital discharge planning services and scope of services provided within the facilities.
• Demonstrated ability to work effectively with a broad range of constituents, including consumers, social services and housing providers, volunteers, government officials, community members, boards, high-level management, elected officials, advocates, government and agency staff, and others.
• Excellent verbal and written communication skills.
• Experience gathering and utilizing data and generating reports for system improvements and for presentations to management staff and others.
• Demonstrated ability to simultaneously manage multiple tasks/projects in detail and meet deadlines.
• Computer skills; knowledge of MS Outlook, Word, PowerPoint, and Excel.
• Must be able to pass a criminal background check on a pre hire/post offer basis.

Desired Qualifications

• Two years recent supervisory experience in mental health setting, preferably mental health residential treatment, Utilization Management or Quality Assurance.
• Two years of recent demonstrated contract management experience, including but not limited to invoice reconciliation, data entry, data validation, and independent quality assurance reviews.
• Knowledge of utilization management strategies and quality management practices.
• Knowledge or experience with ECLS, PDAMS, HMIS.

Additional Position Information