UM Clinical Director of Implementations in Cypress, CA at Beacon Health Options

Date Posted: 10/21/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic Director of Clinical Implementations to join our Utilization Management team in Cypress, CA! The Director of Clinical Implementations will be responsible for partnering with the Clinical Teams for all the service centers and corporate clinical to ensure that clinical implementations are managed effectively and successfully for all implementations including new clients, upsells, new LOB, and new programs. This individual will ensure the delivery of excellent service to internal and external customers across multiple clients and products. Through exceptional interpersonal and communication skills, effective leadership, planning, process management and information analysis, this individual will continually promote a customer focused environment.  This position enhances customer loyalty by ensuring that implementation leads in the various service centers have the resources they need to implement successfully.

This position will be a clinical system expert being able to test and assist in training the MIS system(s). This includes the appropriate testing of system enhancements prior to release to the production user community as well as post release testing of application. Responsible for the development of test scenarios and scripts to validate the technical accuracy of enhancements to core and non-core systems for any service center specific workflows.  Responsible for attending train the trainer sessions and training staff in use of enhancements to the applications and coordinating with service center and National operations on any workflow issues that may occur. May participate in validation of migrated data in support of Model Office for migrations and implementations.

*Time requirements: May entail 6 hours up to 2 days dedicated to testing on weekends or evenings including late evenings several times throughout the year.*

Position Responsibilities:

  • Maintains standardized corporate templates of materials utilized in implementations including those corporate materials reviewed and approved by CMMC.
  • Collaborates with the management team in the corrective action process by gathering documentation regarding noncompliance in meeting required standards. Contributes to performance improvement plans and participates in discussions regarding individual performance and system issues.
  • Ensure processes are in place to support compliance with all state and federal laws (HIPAA), regulatory requirements, accrediting agencies (NCQA and URAC) as well as Beacon clinical criteria and policies and procedures.
  • Works in collaboration with national implementation team and provides SME content on all clinical areas; including but not limited to: Mixed Service Protocol, delegation agreements, Prior authorization requirements, transition of care expectation and timeline, benefits design/limitations and parity compliance, etc.
  • Attends all new client meetings and provides direction and recommendation to the new client related to clinical items and implementation discussions.
  • Identifies new client report needs and submits DMATT
  • Ensures clinical UM team adds all new clients to existing clinical reports and finance reports
  • Identifies improvements or training opportunities and develops/presents quality improvement training materials to improve overall service quality. Identifies trends and concerns in system use and workflows and applies corrective actions as necessary to meet business needs.
  • Develops ideas for performance improvement, service delivery, and cross-functional initiatives that contribute to department success.
  • Collaborates with the management team on new client implementation activities, including development/presentation of training materials, to ensure all home service center and client performance expectations are met. Assists service center clinical implementations staff in training of new staff working with system trainers. Develops and provides clinical trainings as necessary.
  • Using approved documentation performs testing of core and non-core system enhancements to assure product performs in a satisfactory manner. Maintains a log or record of problems encountered during testing. Assists in validation of migrated and converted data in support of Model Office procedures. Participates in post-production testing at various releases during year.
  • Designs and develops test scenarios and scripts to validate software product meets requirements of the approved functional and technical specifications and does not interfere with existing service center specific workflows. If issue is identified works with service center management and national operations to correct issue in application or modify workflow to accommodate system change.
  • Assists in the researching of errors identified in Level III testing.
  • Coordinates with corporate trainers in the training of personnel in correct procedures for data entry and updates of clinical information with new enhancements in the Clinical Connect application while utilizing release notes and other materials provided by National IT Trainers during the Train the Trainer Sessions with releases.
  • Assists in researching and answering questions from users regarding new system functionalities and enhancements.
  • Assists in researching reported production system errors within the service center.

Position Requirements:

  • Education: Bachelor’s Degree and/or Master’s Degree in Social Work or one of the other core mental health disciplines required
  • Licensures: Current, valid, and unrestricted licensed behavioral health clinician and practice within the scope of their licensure
  • Relevant Work Experience: 4 years clinical/administrative experience required and 2 years behavioral health experience required
  • Knowledge, Skills, & Abilities:
    • Clinical/administrative experience in a supervisory or team lead role preferred.
    • Experience with design and development of MIS systems, testing and training preferred.
    • Requires solid knowledge base and working knowledge of mental health systems with clear understanding of psychiatric clinical case management and Employee Assistance Programs.
    • Requires effective management and interpersonal skills
    • Must be able to articulate programs verbally and in writing as necessary.

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