Case Manager-Quality

Job Description

CLASSIFICATION DETAILS

DEPARTMENT: Community Mental Health

HIRING AUTHORITY: Chief Executive Officer

FLSA STATUS:  Non-exempt

EMPLOYMENT RELATIONSHIP:  Just cause subject to probationary period

CURRENT HOURS AND STARTING TIME:  Full-time position (37.5 hours per week)  The starting time for this position is 8:30 a.m. Monday – Friday.

GENERAL SUMMARY: 

Under direction, maintains a provider monitoring list, schedules monitoring visits to providers, and utilizes monitoring tools. Maintains administrative records. Coordinates, consults, and provides liaison work with providers to ensure quality services. Contributes expertise from professional discipline to team planning and quality processes.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Performs quantitative reviews of the individual records and provider settings.

Completes quality assessment tools, compiles information from the surveys, consults with the Quality Coordinator regarding corrective action plans, monitors corrective action plans, and reports compliance to standards and adherence to provider contractual obligations in an effort to ensure the least restrictive level of care is provided to persons served.

Monitors a subset of individual progress notes to ensure they have been monitored by the primary provider of service, tie back to the person-centered plan and support medical necessity.

Maintains accurate and up-to-date documentation, including standardized assessment forms to ensure accurate documentation of surveys, health and safety issues, training, compliance with Home and Community Based Services (HCBS) standards, and incident reports.

Ensures administrative paperwork is accurate and up-to-date, including, staff activity logs, statistical reports, attendance, and mileage reports.

Completes and maintains Community Mental Health and Department of Mental Health statistical reports, as needed.

Participates in agency and system staff meetings, provider meetings, and compliance meetings as assigned.

Documents clinical concerns regarding individual and/or provider services and requests consultations when indicated.

Performs assessments in both licensed and unlicensed settings to assist in the provision of a more individualized plan of service and payment structure.

Serves on Community Mental Health or community-based committees, as assigned.

Performs related duties as assigned.

QUALIFICATIONS

Required Education and Experience

• A Bachelor’s Degree in Psychology, Social Work, Special Education, Counseling or other mental health related field from an accredited college or university
• One (1) or more years of professional experience working in case management or supports coordination with persons who have mental illness or intellectual/developmental disabilities
• Meet qualifications as specified in the MDHHS Michigan PIHP/CMHSP Qualifications per Medicaid Services as a Qualified Mental Health Professional (QMHP) and or Qualified Intellectual Developmental Professional (QIDP);
  1. Individual with specialized training or one year of experience working with a person who has mental illness; and is a psychologist, physician, educator (with a degree in education from an accredited program), social worker, physical therapist, occupational therapist, speech-language pathologist, audiologist, registered nurse, therapeutic recreation specialist, licensed or limited licensed professional counselor licensed/limited-licensed professional counselor, licensed or limited licensed marriage and family therapist, or a licensed physician’s assistant; or
  2. An individual with at least a bachelor’s degree in a human services field

Preferred Education and Experience

• A Master’s Degree in Psychology, Social Work, Special Education, Counseling or other mental health related field from an accredited college or university
• Three (3) or more years of case management or supports coordination experience working with persons who have mental illness and/or Intellectual Developmental Disabilities
• One (1) or more years experience providing Severity Intensity Scale (SIS) assessments and reviewing the interrater reliability of standardized tests

Required Licenses or Certifications

Preferred Licenses or Certifications

COMPETENCIES FOR SUCCESSFUL PERFORMANCE OF JOB DUTIES

Knowledge of:

• Considerable knowledge of the subject manner related to work assignments and can make decisions within the context of general guidelines and procedures
• Knowledge of applicable computer applications

Skill in:

• Using good professional judgment for the welfare and safety of our consumers
• Excellent organizational skills with the ability to manage multiple priorities
• Analyzing information and completing reports

Ability to:

• Collaborative:  Approaches all situations with a teamwork and solution focused mindset demonstrated through active participation in meetings, volunteering to assist teammates and other departments as appropriate.  Examples include participation in internal and external committees, subcommittees, process improvement groups or other multi-organizational initiatives
• Accountable:  Takes ownership and empowers others to do the same as evidenced by identifying solutions and acting on job responsibilities and organizational objectives, daily
• Respectful:  Treats people with dignity while honoring individual differences demonstrated through use of positive and encouraging statements and/or interactions to, about and/or with colleagues and persons served; evidenced by supervisor observation, feedback from other department staff and leadership
• Work in an environment which embraces the county’s Dignity Campaign
• Effectively speak, write, and understand the English
• Effectively speak, write, and understand a language other than English is preferred
• Understand and carry out oral and/or written instructions
• Accurately organize and maintain paper documents and electronic files
• Maintain the confidentiality of information
• Work independently