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Clinical Operations Manager

2 months ago

Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time
Job Overview

The Clinical Operations Manager is tasked with overseeing the daily functions of clinical teams to guarantee that care standards and practices align with state regulatory guidelines.

Key Responsibilities:

  • Develop and nurture a proficient team through effective recruitment, training, performance evaluation, coaching, team development, and succession planning.
  • Establish policies and procedures to enhance the efficiency of the Clinical Department.
  • Conduct and supervise clinical quality audits and provide constructive feedback.
  • Track productivity and ensure compliance with established standards.
  • Provide ongoing supervision and maintain documentation in accordance with industry standards.
  • Engage in both internal and external meetings to assess and refine services and resources to effectively meet member needs.
  • Facilitate access for Clinical Care Managers to provider sites for member interactions.
  • Accompany Clinical Care Managers and Supervisors in community settings for 10 to 15% of work time to deliver continuous clinical supervision and insights.
  • Conduct staff meetings to offer clinical consultation on various cases.
  • Collaborate with Physician Advisors to ensure suitable consultations for high-risk members.
  • Proactively manage crisis situations as they arise.
  • Work closely with Clinical Care Management Coordinators from other teams to ensure consistent and comprehensive care management.
  • Partner with the Quality Management Department to identify key indicators of provider stability and ensure monitoring and corrective actions are taken as necessary.
  • Maintain effective collaboration with other departments to promote interdepartmental efficiencies.
  • Ensure clear communication of critical information related to members and providers across disciplines.
  • Gather and analyze data pertinent to team members, clinical operations, and staff performance to inform interventions.
  • Ensure that direct reports are well-versed in evidence-based practices and that these practices are regularly discussed in supervisory sessions.
  • Utilize data-driven decision-making processes.
  • Exemplify and demand outstanding customer service in interactions with members and providers.
  • Perform on-call responsibilities as required.
  • Execute additional duties as assigned.

Team-Specific Duties:

  • Oversee the operations of specialized clinical programs.
  • Continuously enhance and design care management and longitudinal care coordination strategies for the team, exploring opportunities for growth.
  • Establish relationships with behavioral and physical health providers to create effective communication and collaboration protocols.
  • Collaborate with system partners (e.g., Community-Based Organizations, PH-MCOs, DBHIDS) to address members' Whole Person-Centered Care using evidence-based practices.
  • Focus on targeted interventions aimed at reducing readmissions and service utilization.
  • Analyze data to identify members with specific behavioral health needs and develop protocols to connect them with appropriate support, including Evidence-Based Practices (EBPs) when feasible.
  • Work closely with the Integrated Care Plan (ICP) team and other departmental teams to promote integrated care coordination.

Position Qualifications:

  • Education: Master’s degree in Social Work or a related field.
  • License/Certification: Preferred licensure; progress towards licensure must be made within an agreed timeframe as a condition of continued employment. PA Child Abuse Clearance is required.
  • Experience: Minimum of 3 years of post-graduate experience, including at least 1 year in a supervisory role.

Required Skills:

  • Excellent verbal and written communication and presentation abilities.
  • Adept at reading, analyzing, and interpreting utilization reports.
  • Understanding of mental health and substance abuse services or interventions.
  • Strong problem-solving capabilities.
  • Proficient in MS Office and able to type at least 20 words per minute.
  • Ability to work collaboratively in team environments.
  • Exceptional organizational skills.
  • Compliance with HIPAA regulations.
  • Strong clinical competencies.
  • Ability to provide clinical supervision for complex member presentations.
  • Critical thinking and clinical problem-solving skills.

Leadership Competencies:

  • Strategic Thinking: Comprehend and integrate the long-term vision of the organization, focusing current activities on critical objectives to achieve future success.
  • Leadership: Effectively manage and guide efforts to address challenges and drive continuous improvement in programs, services, and processes.
  • Employee Development: Recognize the importance of hiring, assessing, developing, and retaining high-quality talent, providing timely feedback to enhance performance.

Work Conditions:

  • Travel may be required, including out-of-state and overnight trips.
  • Regularly involves walking, standing, bending, sitting, reaching, and repetitive movements throughout the day.
  • Ability to use computers and office equipment to fulfill daily responsibilities.
  • Work is primarily indoors in adequately lit and ventilated areas, with some temperature fluctuations.
  • Must adapt to the continuous changes and demands of the role.

Equal Employment Opportunity:

We are committed to fostering a culture of diversity, inclusion, and belonging. We are an equal opportunity employer and do not discriminate in any personnel action based on race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, disability, protected veteran status, genetic information, or any other characteristic protected by law.