Establish, maintain, and leverage relationships with community partners, facilitate meetings and ensure accurate and timely minutes are taken and filed.Ensure members are treated with dignity and respect, and professionalism is maintained through interactions with community partners and interdepartmental interactions.Staff development of direct reports, goal setting and monitoring with a data-driven approach.Oversee the PAR process and evaluations to ensure medical necessity criteria is met and documentation supports disposition decision making.Develop and analyze interventions for improvement in service delivery according to data received, gathered, and tracked. Establish evidence-based practices and interventions to support goal-driven metrics in the PIHP Crisis Services Department.Increase cooperation and contact between all entities associated with member care.Develop knowledge and familiarity with all processes and procedures to ensure implementation of all data-driven metrics per state standards.Report on outcomes and track emergency department utilization, utilization of various levels of care in crisis, referrals to external partners, and state driven metrics within DWIHN.Develop accurate and timely reporting methods to gather and track data, using targeted interventions where necessary to improve service delivery that is fiscally responsible and within medical necessity.Facilitate meetings where needed with the provider network to address issues, successes, and areas of opportunity for quality improvement.Utilize knowledge of the community’s behavioral health services networks to assist consumers in obtaining services that suit his/her individual medical, psychiatric and social support needs.Manage a report of members in the ED more than 23 hours after disposition.Monitor discharge planning efforts for members without an assigned CRSP.Monitor Single Case Agreements (SCA) with out-of-network facilities.Monitor and ensure proper County of Financial Responsibility (COFR) determinations.Communicate effectively with stakeholders.On-call rotation for after-hours, weekends and holiday coverage for FT and PT as specified and needed by leadership. Telephonic coverage as neededAdditional tasks as deemed necessary.

Knowledge of DWIHN policies, procedures, and practices. Knowledge of the DWIHN provider network and community resources. Knowledge of the Michigan Mental Health Code. Knowledge of behavioral health and mental health principles and practices. Knowledge of the Michigan Medicaid Provider Manual. Knowledge of MWHIN. Knowledge of compliance standards. Knowledge of call screening techniques and phone etiquette.Knowledge of policies and procedures for receiving and processing emergency calls.Knowledge of customer service principles and practices.Knowledge of crisis training and experience in de-escalation, i.e., suicide prevention, development of crisis plans, trauma informed care, etc.Knowledge of emergency and general dispatch procedures and practices.Knowledge of medical and insurance terminologyAssessment skills.

Evaluation skills.Decision Making skills.Interpersonal skills.Customer Service skills.Communication skills.Active Listening skills.Computer skills (Word, Excel, Access, Power Point, Outlook, Teams).Teamwork Skills.Ability to communicate orally.Ability to communicate in writing.Ability to work effectively with others.Ability to work with an ethnically, linguistically, culturally, economically and socially diverse population.Judgement/Reasoning ability.

A master’s degree in social work, Psychology, Counseling, Nursing, Human Services, Social Services or a related field.

Five (5) years of clinical experience as an LLMSW in a psychiatric or behavioral health setting

At least Three (3) years of professional experience in the following:Supervision and/or management in a community mental health settingBehavioral Health Utilization Review

Work is usually performed in an office setting but requires the employee to drive to different sites throughout Wayne County and the State of Michigan. This position can work remotely with supervisory approval.