Head of Customer Service (Remote)

Director of Residential Services

Under the general supervision of the Vice President of Clinical Operations or Associate Vice President, the Director of Residential Services manages services to those that are receiving SMI/IDD Community Living Support and Personal Care Services in various specialized residential settings.

Principal Duties And Responsibilities:

Administration & Support:

Oversee all policies, processes and protocols involving the completion of the comprehensive initial assessments, reassessments, and the gathering of standard and pertinent information about member needs that leads to the development, monitoring and facilitation of member residential and/or supportive service plans, reviews, and updates. Oversees compliance with all relevant DWIHN Policies and Training Guidelines as well as state and federal licensing standards and regulations for residential services and homes. Develops and implements department process flows, instructions, and forms. Provides Direct Care Staff training and feedback. Facilitates DWIHN's strategic planning process by ensuring the development of goals, monitoring the accomplishment of priority goals via status reports, and ongoing data review. Oversee Residential Service Assessments, Home and Community Based Services (HCBS), and Certification and Home Quality Reviews.

Customer Service:

Notifies Clinically Responsible Service Providers (CRSP) of their designated members who do not meet criteria for specialized residential services in relation to LOCUS score and/or current Individual Plan of Service (IPOS). Communicates progress on goals and quality outcomes. Serves as a communication liaison for licensing representatives.

Project & Program Management:

Manages services to those that are receiving SMI/IDD Community Living Support and Personal Care Services in various specialized residential settings.

Technical/Professional Skills:

Develop and implement corrective action plans when necessary. Create benchmarks for Residential Care Specialists to assess and manage approved services for members receiving services. Oversee data collection for the purpose of care coordination and authorization of care. Provide technical assistance for Affiliated providers regarding behavioral care coordination practices.

Clinical:

Review and evaluate data/records and implement strategies to improve the provision of residential services and clinical quality outcomes. Assess client satisfaction and implement proactive action plans and effective communication and follow-up to address client concerns. Develop and implement Standardized Residential Daily Progress Notes.

Industry-Specific Duties:

Supervise all residential placements and services including hospital discharges and Supportive Service programs (SIL and CLS). Oversee the facilitation of transitions of care. Oversee the development, monitoring, and management of care coordination activities. Oversee the coordination and provision of treatment/discharge planning for members transitioning between levels of care. Provide guidance, training, evaluation, and follow-up for residential service providers. Provide immediate responses and actions for recommended facility closures including coordinating and managing the relocation of all members residing in the facility. Oversee and process all housing and in-home supportive service referrals and requests. Implement Care Management protocols related to behavioral health concerns. Participate in team meetings, pre-release meetings, placement review committee meetings, and discharge planning meetings.

Miscellaneous:

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 health and mental health principles and practices. Knowledge of Residential Services practices and principles. Knowledge of screenings, assessments, and authorizations for people qualifying for residential services. Knowledge of care coordination rules and protocols. Knowledge of the Michigan Medicaid Provider Manual. Knowledge of MHWIN. Knowledge of the LOCUS model. Knowledge of the clinical care process (screening, assessment, treatment planning, case management and continuing care). Knowledge of and ability to use screening and assessment tools for behavioral health services. Knowledge of the Adult continuum of care for all disability designations (I/DD, SMI, Co-Occurring Disorder). Knowledge of Quality Management and Quality Improvement principles and practices. 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 ICD 9, CPT Codes, DSM-IV Statistical Manual or most current diagnostic edition. Knowledge of compliance standards. Knowledge of Medical Necessity Criteria for Behavioral Health Services. Knowledge of the Federal Confidentiality Regulations, 42 CFR, Part 2. Knowledge of the Professional Code of Ethics. 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. Knowledge of Service Utilization Guidelines. Knowledge of Community Mental Health Services Programs (CMHSP) and Prepaid Inpatient Health Plans (PIHP). Knowledge of NCQA requirements and the accreditation process. Knowledge of Medicaid insurance principles and practices. Knowledge of HEDIS measures and standards. Knowledge of the complaints, grievances, and appeals (including Recipient Rights appeals) processes and procedures. Knowledge of nursing home practices and procedures. Supervisory skills. Management skills. Leadership skills. Executive skills. Team Leadership skills. Administration skills. Training skills. People management skills. Project management skills. Action planning skills. Strategic thinking skills. Strategic planning skills. Emotional intelligence skills. Corrective Action skills. Assessment skills. Evaluation skills. Organizational skills. Report writing skills. Problem Solving skills. Decision Making skills. Critical Thinking skills. Presentation skills. Interpersonal skills. Public Speaking skills Customer Service skills. Communication skills. Teaching skills. Written communication skills. Computer skills (Word, Excel, Access, Power Point, Outlook, Teams). Teamwork Skills. Team building skills. Relationship-building 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.

Required Education:

A Master's Degree from a recognized college or university in the Human Services, the Social Services, Nursing (a Bachelor's Degree will be accepted), Public Health, Healthcare Administration, Health Management, Psychology, Counseling, Social Work, or a related field.

Required Experience:

Eight (8) years of full-time paid professional experience working in a human service, social service, mental health, or behavioral health setting.

And

Five (5) years of full-time paid professional experience as an executive, administrator, manager or supervisor in a human service, social service, mental health, or behavioral health setting.

And

Three (3) years of professional experience performing screenings, assessments, or authorizations in a behavioral healthcare or mental health setting.

And

Two (2) years of full-time paid experience coordinating residential placements for a human service, social service, or mental health organization.

Required License(S):

A Valid State of Michigan clinical licensure: RN, LMSW, LMHC, LPC, LLP or PhD.

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 position can work remotely with supervisory approval. Currently this position is primarily a remote position.

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 accommodations 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