Program Analyst

2 months ago

Detroit, United States Detroit Wayne Mental Health Authority Full time
Job DescriptionJob Description

Under the general supervision of the Health Home Director, the Program Analyst – CCBHC provides administrative oversight of the Certified Community Behavioral Health Clinic (CCBHC) State Demonstration and creates, directs, and implements its policies and procedures.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Serves as a liaison between CCBHC Demonstration sites in PIHP Region 7 and MDHHS, communicating regional feedback and provider needs.
  • Provides DWIHN and CCBHC demonstration sites in the region with expertise on the CCBHC philosophy of care and certification requirements.
  • Provides oversight and technical assistance for the CCBHC demonstration.
  • Monitors and ensures the ongoing compliance and quality of CCBHC Demonstration sites in DWIHN’s region.
  • Maintains knowledge of federal and state requirements related to CCBHC site certification.
  • Monitors Region 7 CCBHC sites for compliance, quality, and sustainability.
  • Communicates with the Health Home Director and MDHHS about identified areas of concern.
  • Makes policy recommendations to MDHHS with the Health Home Director.
  • Works with the DWIHN Managed Care Operations Department to ensure proper credentialing of CCBHC sites and reviews CCBHC site Designated Collaborating Organization (DCO) agreements.
  • Collaborates with CCBHC Demonstration sites and DWIHN Finance Department to ensure accurate and timely CCBHC financial reporting is submitted to MDHHS.
  • Monitors reporting deadlines for CCBHC sites and ensures reporting requirements are met.
  • Works with CCBHCs to establish a timeline to meet MDHHS reporting deadlines.
  • Distributes data requests from MDHHS to CCBHCs for data collection.
  • Validates submissions by reviewing for completion and evaluating for reasonability and accuracy of data requests prior to sending to MDHHS. This includes but is not limited to quality metrics, cost reports, level of care (LOC) data, reconciliation templates, and ad-hoc requests by MDHHS.
  • Works closely with CCBHCs to ensure the CCBHC can successfully collect required clinic-reported quality measures.
  • Collaborates with CCBHC sites to remedy data collection issues to ensure accuracy of metric reporting.
  • Provides CCBHC technical assistance to CCBHC Demonstration sites.
  • Provides support to CCBHCs related to Health Information Technology, including Waiver Support Application (WSA), CareConnect360, PIHP EHR, and Health Information Exchange (HIEs).
  • Collaborates with internal DWIHN departments to resolve CCBHC issues related to Claims, EHR, Finance, Access, and other disciplines.
  • Monitors and processes CCBHC assignments and transfers in the Waiver Support Application (WSA).
  • Provides WSA technical assistance in partnership with MDHHS.
  • Communicates with providers and other PIHP regions regarding transfers and care coordination across regions.
  • Reviews and analyzes developing CCBHC policy and programmatic updates.
  • Assists the Health Home Director with identification and implementation of operational and process changes resulting from policy change and program requirements.
  • Works with MDHHS and CCBHC sites to validate encounter reporting and correct any discrepancies.
  • Educates internal and external stakeholders about the CCBHC philosophy of care, what it can offer people served, and how it will impact internal operations.
  • Participates in the identification of quality care indicators and outcome objectives.
  • Oversees the collection and review of data related to program performance.
  • Performs related duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES (KSA’S)

• 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 MDHHS policies, rules, regulations, and procedures.

• Knowledge of Federal policies, rules, regulations, and procedures as it relates to DWIHN.

• Knowledge of Behavioral Healthcare management principles and practices.

• Knowledge of MHWIN.

• Knowledge of Certified Community Behavioral Health Clinics and the Michigan State Demonstration

• Knowledge of the continuum of care for persons diagnosed with mental illness, substance use, and serious emotional disturbance.

• Knowledge of Integrated Care services for behavioral health patients.

• Knowledge of Utilization Management practices and principles.

• Knowledge of managed care practices and principles.

• Knowledge of Evidence Based Practices for the behavioral health field.

• Knowledge of Medicaid, local, regional, and national codes, laws and regulations.

• Knowledge of compliance standards.

• Knowledge of the Federal Confidentiality Regulations, 42 CFR, Part 2.

• Knowledge of Medicaid/Block Grant eligibility requirements.

• Knowledge of documents / regulations that govern the provision of mental health services, e.g., Medicaid Manual Mental Health and Substance Abuse Chapter III, State Plan for Medicaid, Michigan Department of Health and Human Services Quality Plan, BBA requirements and the Mental Health Code.

• Knowledge of the Code of Federal Regulations, Balanced Budget Act, Bureaus of Adult and Licensing rules, DWIHN divisions.

• Knowledge of Community Mental Health Services Programs (CMHSP) and Prepaid Inpatient Health Plans (PIHP)

• Knowledge of NCQA requirements and the accreditation process.

• Knowledge of contracting policies and procedures.

• Knowledge of Medicaid insurance principles and practices.

• Knowledge of HEDIS measures and standards.

• Management skills.

• Leadership skills.

• Administration skills

• People management skills.

• Project management skills.

• Strategic thinking skills.

• Report writing skills.

• Critical Thinking skills.

• Interpersonal skills.

• Communication skills.

• Training skills.

• Computer skills (Word, Excel, Access, Power Point, Outlook, Teams).

• Budgeting skills.

• Ability to work with an ethnically, linguistically, culturally, economically, and socially diverse population.

• Judgement/Reasoning ability.

REQUIRED EDUCATION:


A Master’s Degree from a recognized college or university in the Human Services, the Social Services, Psychology, Counseling, Social Work, Health Administration, or a related field.

REQUIRED EXPERIENCE:


Five (5) years of professional experience in a behavioral healthcare or mental health setting.

REQUIRED LICENSE(S).

A valid State of Michigan Driver’s License with a safe and acceptable driving record.

WORKING CONDITIONS:

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 description is not intended to be a complete statement of job content, rather to act as a general description of the essential functions performed. Management retains the discretion to add or change the position at any time.

Please Note: DWIHN requires proof of being fully vaccinated for COVID-19 as a condition of employment. Medical or religious accommodation or other exemptions that may be required by law, will be approved when properly supported. Further information will be provided during the recruitment process.

The Detroit Wayne Integrated Health Network is an Equal Opportunity Employer

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