Supervisor of Clinical Support Services and Quality

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Supervisor of Clinical Support Services and Quality to join our growing team.

Job Summary:

The Supervisor of Clinical Support Services and Quality is responsible for the overall behavioral health review process of Family Support Services Program and the Utilization Management Quality Program.

The position is remote, but candidates must possess an Illinois clinical license at time of hire.

Responsibilities:

• Oversight of the IL Family Support Program review process by conducting behavioral health reviews for adolescent patients requiring extensive support services related to emotional disturbances that cannot be managed solely in traditional outpatient settings
• Answer Family Support Program related correspondence received via a call center approach and mailbox utilizing proper telephone etiquette and judicious use of other verbal and written communications per contract and guidelines
• Coordinates program services and review activities associated with quality reviews and family support program process. Ensure that all cases requiring review are completed in a timely manner in accordance with policy and contract requirements
• Performs quality review activities timely and ensure Quality Improvement Plans are received from providers and monitored. Present findings, conclusions, and recommendations as needed
• Identifies opportunities for improvement and recommends changes to processes as needed
• Develops, coordinates, and conducts external education as needed
• Assists with internal education classes as requested
• Assists in preparing and submitting reports and/or deliverables as required
• Attend meetings and correspond with client and external providers
• Maintain monthly log of validations and monitoring confirmed quality issues for reporting to client
• Conduct quarterly focused record reviews to identify patterns of quality concerns, that may require further monitoring, investigation, and/or reporting to HFS
• Foster positive and professional with internal and external customers to ensure effective working relationships and team building to facilitate the review process
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
• Performs other duties as assigned

Required qualifications:

• Active, unrestricted Registered Nurse (RN) license in Illinois
• Bachelor's degree in nursing
• 3 years of clinical experience as a registered nurse
• 2 years of experience in behavioral health, utilization management (UM) and/or quality improvement combined as an RN in a managed care/healthcare setting
• Knowledge of medical/psychiatric and psychological terminology, mental health assessment tools, treatment plans, delivery of behavioral health services and an understanding of residential care and outpatient community mental health services
• Proficient knowledge in InterQual, Milliman, and/or ASAM guidelines

Preferred qualifications:

• Reside in Illinois
• Excellent written and verbal communication and presentation skills. Excellent interpersonal skills
• 1+ years of experience identifying organizational needs and recommending appropriate improvements to increase organizational effectiveness
• 1+ years of experience working with Medicaid population or other government programs
• 1+ years of experience in teaching techniques and methods to enhance learning
• Ability to manage projects independently and assume responsibility for successful completion
• Ability to develop and maintain strong working relationships with internal and external clients/customers/members

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

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