Mental Health Clinician III

About the Opportunity

Stanislaus County Behavioral Health and Recovery Services is dedicated to principles of behavioral health that address both mental health and substance use disorders. Our services span inpatient and outpatient psychiatric care, substance use disorder support, behavioral health education, and advocacy, among others. We operate throughout Stanislaus County, managing sites and collaborating with community agencies and County departments.

The Mental Health Clinician III will provide clinical administrative support and technical assistance in the areas of compliance, privacy, and ethics for the Mental Health and Drug Med-Cal Organized Delivery System plans.

This recruitment is to fill a vacancy for the following BHRS Program: Compliance, Privacy, and Ethics. This team provides support and technical assistance to the BHRS Mental Health and Substance Use Disorder departments in the areas of ethical and compliance standards, maintaining member privacy, State and internal audits, and training. Our customers are BHRS and contract provider agency staff, from line and support staff through Senior Leadership. Our goal is to support our customers in meeting BHRS clients' needs and maintaining high standards and compliance with all regulatory requirements.

Quality Services. This team provides comprehensive support and technical assistance to the BHRS Mental Health and Substance Use Disorder departments. We focus on enhancing service quality by upholding regulatory standards, protecting beneficiary rights, and facilitating continuous improvement through state and internal audits. Additionally, we offer targeted support to empower staff at all levels, from frontline and support staff to senior leadership, to deliver quality care. Our primary objective is to equip our customers, including BHRS staff and contract provider agencies, with the tools and knowledge needed to excel in their roles, whether that be administrative or clinical. By doing so, we ensure that they not only meet the regulatory requirements but also deliver the highest level of care to clients, fostering an environment of continuous progress.

Workforce Development and Training. The Workforce Development and Training Department provides effective training that promotes continuous learning and professional development and offers opportunities for staff to maintain their licensure, or re-certification by providing continuing education units. The Workforce Development and Training Department Mental Health Clinician III will assist in the Department's Training Program under the direction and guidance of the Workforce Education and Training Coordinator/Manager. The Mental Health Clinician III will work directly with the different systems of care to assure they are receiving the appropriate and required training to promote their staff's knowledge and quality service for all clients.

Utilization Management/Managed Care. Utilization Management (UM) conducts utilization reviews to ensure compliance with county and state regulations related to access criteria and medical necessity for Stanislaus County Medi-Cal beneficiaries. This position will also provide oversight for compliance with State and Federal requirements to guard against waste, fraud, and abuse. Additionally, UM staff monitor the under and overutilization of services, and track and monitor trends that may potentially negatively impact client care. UM staff also coordinate the development of training resources for all staff related to documentation standards that are related to UM activities.

Typical Tasks

Compliance, Privacy, and Ethics

• Participate in out of county activities related to compliance and privacy such as meetings and annual conferences;
• Conduct audits and monitoring activities of BHRS and its contractors related to Federal and State regulations;
• Assist/Lead with drafting, editing, and finalizing documents, including Compliance policies and procedures;
• Assist/Lead the assignment, monitoring, and validation of General Compliance, Ethics, and Privacy training and reporting;
• Analyze new regulations, provide analysis of those regulations to the Compliance Manager and Compliance Officer, and assist with implementation;
• Communicate verbally & write concise reports regarding findings from program & department audits or monitoring activities;
• Communicate with BHRS and contracted providers regarding the outcomes of reviews and audits or monitoring activities;
• Set priorities and meet multiple, overlapping deadlines;
• Analyze new clinical processes and regulations and assist with implementation through the electronic health record or other necessary platforms;
• Coordinate and collaborate with the Training Department for needed trainings;
• Assist in researching and developing trainings related to noncompliance trends identified in reviews/audits (within scope of competence);
• Manage and validate Corrective Action Plans for multiple types of audits;
• Develop communications to disseminate compliance, privacy, and ethics related topics and requirements to all county and contracted agency staff;
• Assist Compliance Manager in investigations of potential protected health information breaches, ethical and compliance violations, and Medi-Cal fraud, waste, and abuse;
• Review trend analyses provided by staff services analyst related to audits, reviews, and monitoring activities for submission to Compliance Manager for dissemination to BHRS leadership;
• Assist in promoting employee awareness of ethical and compliant practices;
• A strong commitment to and demonstrated skills in provision of culturally competent services to diverse populations, consistently utilizing multicultural skills, knowledge and experience; and
• Other duties as assigned.

Quality Services

• Participate in out of county activities related to Quality Services such as meetings and annual conferences;
• Managing Medi-Cal Certifications for both BHRS and contract providers, including on-site visits;
• Support staff and contractors in the department documentation content and Medi-Cal standards to ensure compliance;
• Assist in organizing, data collecting, and facilitating the State/Federal audits for the department;
• Assist with testing and training electronic health record updates and new releases;
• Assist the state required Performance Improvement Projects;
• Assist with providing support around clinical tasks such as Procedure Codes, EHR clinical forms, and others as assigned;
• Assist/Lead with drafting, editing, and finalizing documents, including department policies related to BHRS Quality Services
• Analyze new regulations related to Quality Services and assist with implementation;
• Provide support to the Quality Management Team;
• Analyze new clinical processes and regulations and assist with implementation;
• Set priorities and meet multiple, overlapping deadlines;
• Communicate verbally & write concise reports;
• Assist in promoting employee awareness of ethical and compliant practices;
• A strong commitment to and demonstrated skills in provision of culturally competent services to diverse populations, consistently utilizing multicultural skills, knowledge and experience
• Other duties as assigned.

Workforce Development and Training

• Provide culturally competent supervision for assigned clinical and/or interns;
• Provide presentations on various identified trainings for department and contract agency staff;
• Train in ethical practices and compliance issues;
• Knowledge of Mental Health Services Act/ Behavioral Health Services Act essential elements;
• Strategically build and maintain relationships with co-workers, community partners across the county, and participate in a wide range of community collaborative and capacity building efforts, and provide education to reduce stigma;
• A strong commitment to and demonstrated skills in provision of culturally competent services to diverse populations, consistently utilizing multicultural skills, knowledge and experience;
• Evaluate employee performance related to progress toward licensure and ability of staff they are clinically supervising;
• Provide group and individual clinical supervision and training focusing on case formulation and clinical diagnosis;
• Other duties as assigned.

Utilization Management/Managed Care

• Monitor all Utilization Management (UM) delegated activities
• Review and authorize documentation and requests for services
• Assist with monitoring concurrent chart review contract and support any sub-acute inpatient chart review, partial hospitalization chart review, and residential chart review, which includes provider appeals
• Attend coordination meetings as needed, such as Eating Disorder treatment and/or timely discharge planning from inpatient hospitalizations
• Perform Mental Health and DMC-ODS Audit Reviews and track trends
• Communicate verbally and in writing, concise audit summaries regarding BHRS audit results
• Coordinate and collaborate with the Training Department for needed trainings
• Set priorities and meet multiple, overlapping deadlines
• Work in a high paced environment which may include self-led learning
• Collaborate with BHRS Compliance Officer, Quality Services Manager, Compliance & Privacy Manager
• Assist with preparation for external audits and reviews
• Participate in committee meetings, as needed
• Other duties as assigned

Minimum Qualifications (Knowledge, Skills, Abilities, Education/Experience)

KNOWLEDGE ALL positions:

• Possess all the knowledge of a MHC II classification including clinical licensure in addition to;
• Extensive experience and training in the provision of culturally competent services to diverse populations and groups;
• Regulatory compliance issues, departmental policies, documentation standards, legal and ethical issues and quality management; and