Director, Clinical Services in Roseland, NJ at Beacon Health Options

Date Posted: 5/27/2018

Job Snapshot

Job Description

About the Position:

The Director, Clinical Services is responsible for clinical oversight of utilization management and case management activities of the clinical department while ensuring compliance with state and national governance regulations (i.e., NCQA/URAC and other applicable standards of accreditation and/or regulation).  This includes management of the application of clinical workflows and processes, identifying, improving and measuring processes to enhance operations, standardizing best practices and ensuring compliance/quality standards.  The Director is responsible for day-to-day management of clinical department and clinical client relationship, including evaluation of current priorities, allocation of resources to support daily and strategic objectives, and communication of client expectations to the account management and operations teams.

Position Responsibilities:

  • Directs utilization management and case management programs in the development of clinical programming to improve the health outcomes.
  • Collaboratively participate and oversee the development, implementation and interpretation operating policies, procedures, and performance standards.
  • Provides direct clinical and administrative supervision for clinical staff; responsible for interviewing, hiring, orienting, training and evaluating staff.
  • Serve as member of the utilization management committee; collaborates with VP to monitor utilization and case management trends and formulates strategies to manage costs.
  • Monitors overall compliance related to contractual performance metrics related to completion of assessments, care plans and account specific performance standards.
  • Collaborates with Finance Partner regarding the overall clinical department operations budget.
  • Represent Beacon at client meetings; maintain a positive interaction with external customers by supporting the overall goals of the company.
  • Perform other duties as assigned.

Position Requirements:

  • Education:  Master’s degree required in a Mental Health or related discipline
  • Licenses: Independent NJ LCSW Licensure            
  • Relevant Work Experience:  At least 4-7 years combined direct behavioral health, supervisory and/or managed care experience required. Proven ability to manage a clinical program through financial and clinical data analytics and trend analysis.  Demonstrated leadership skills and supervisory experience, including the ability to deliver outstanding team performance metrics.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled