Director Utilization Management Jobs in Colorado

Department Information This position is open to current Colorado residents only. Located within the Colorado Department of Human Services (CDHS), Civil and Forensic Mental Health Services (CFMH) operates Colorado's two mental health hospitals, the Forensic Services Division, the Division of Mental Health Transitional Living (MHTL), Adolescent Psychiatric Residential Treatment Facility, the Outpatient Services Division, and Enhanced Placement, Incompetency, and Civil Committment (EPICC) services. CFMH provides a continuum of mental healthcare services for civilly- as well as justice -involved individuals.

Civilly certified patients are individuals who have been committed by a civil (probate) court into the care and custody of CDHS because they have serious and persistent mental health conditions. Justice-involved individuals are those who are charged with a crime and have been determined to have a mental or developmental disability that prevents them from assisting in their own defense or rationally understanding the criminal court proceedings, a mental condition that significantly impairs their ability to form a specific intent or understand the full impact of their choices, or have been found not guilty by reason of insanity. CFMH works across the legal system to provide evaluations, treatment, placement, and case management for these individuals.

EPICC is the newest part of this continuum and presently encompasses two subdivisions which include the Bed Utilization Management section and Care Navigation Services. Bed Utilization Management is responsible for the oversight, coordination, metrics, and communications related to the overall inpatient bed capacity managed by CFMH (i.e., MHPs, Jail-Based programs, and private hospital contractors). That section also provides project coordination and necessary admissions-related information in fulfillment of Federal Consent Decree requirements, as well as consultation with the Office of the Attorney General to represent CFMH within Show Cause hearings

Care Navigation Services (CNS) has been created to address recent changes to Colorado's statutory framework governing competency to proceed in criminal cases, which established new processes to transition certain defendants from the criminal justice system to the civil judicial system when criminal prosecution is no longer the most appropriate disposition. These new processes include transitioning from restoration commitments to civil commitments for individuals with mental health disorders, and enhanced protective placements (EPP) for individuals with intellectual and developmental disabilities [IDD] or neurocognitive disorders. The mission of the Care Navigation team is to provide supervision and care coordination for individuals who have been formally charged with a felonious crime of violence or unlawful sexual behavior and who have been found by a presiding court to be both Incompetent to Proceed to adjudication (ITP) and Not Restorable to competency within the foreseeable future (ITP-NR) - at which time the courts are required to release such defendants from their restoration commitments.

The CNS team works within a variety of community, criminal justice, and secure settings (e.g., mental healthcare agencies, jails, courts, hospitals, etc.). The team is responsible for coordinating placement, ensuring a high level of accountability for patient care, providing clear and relevant communications with judicial stakeholders on issues related to progress as well as risk, and (when appropriate) advocating for changes to court-ordered conditions with respect to least-restrictive settings for the provision of services. Furthermore, team members are required to ensure that the skills, knowledge, abilities, and competencies necessary to fulfill their position duties remain current through continuing education, clinical supervision, literature review, and employee development

Description of Job This position is hybrid; 2 days on-site and 3 days remote Please note: These working arrangements are subject to change. What You'll Be Doing: Team Management and Personnel This position provides leadership and direction of the daily operations of the work unit and is the direct supervisor for four (4) full-time employees including a Program Assistant (PAII), the Court Information Administrator (Administrator III), the Benefits Coordinator (Health Professional IV), and the Care Navigation Supervisor (Health Professional V). This position also provides second-level supervision for the six (6) other positions within the work unit and holds regular team meetings.

In order to provide relevant supervision, this position maintains familiarity with the current status and progress of all clients being served by CNS, relevant statutes, and community resources to assist in problem solving and to ensure all clients are receiving an appropriate level of care and/or appropriate intervention. The Director is required to respond to emergency situations directly and also accompanies team members to staffings or treatment-related meetings when support is requested and/or required. Via supervision, the Director provides final approval for all court communication and documentation submissions to include, but not limited to, quarterly reports, annual reports, regressions / progressions, and proposed conditions.

In collaboration with Division leadership, this position assesses the needs for the work unit based on program evaluation, client needs, the division's mission, and resource allocation. The Director supports consistent implementation and compliance with related treatment standards and agency rules / regulations, reports any deficits to leadership, and collaborates in developing operational procedures. The Director serves as an advocate for the work unit and its clients, communicates needs and plans to leadership - which includes analyzing issues related to the services offered by this work unit.

This position must develop a good working knowledge of Colorado regulations and statutes, as well as internal policies and procedures. The Director ensures that effective services are being provided by developing, implementing, and monitoring staff and client engagement and quality of services and work products. Should there be the need for quality improvement, the Director is responsible for identifying such needs and developing a corrective plan of action to present to leadership.

To support efficacy, this position creates work unit protocols and audit tools. This position performs functions and responsibilities related to personnel including assignment of work schedules, approval of leave, counseling and mentoring, performance planning, and assessment and administration of corrective and disciplinary action pursuant to State Personnel Rules. This position monitors staff productivity and efficiency and oversees their compliance with specific competency requirements.

The Director provides strategic planning and staff projections for review by leadership. The Director possesses specialized knowledge within the population served by CNS and regularly participates in committees and work groups. As the Director of this work unit, this position is responsible for all work unit related needs during business hours and after hours as needed.

Lastly, the director is responsible for responding timely to all Colorado Open Records Act (CORA) requests and, in the event of a negative outcome, may be required to participate in communication with CFMH and CDHS leadership and media. Policy and Procedure: This position utilizes best practices to develop and implement operating policies and practice standards for the work unit. This includes standards for treatment planning, and reporting to the court and various agencies.

At the direction of CDHS and CFMH, analyzes current statutes and makes recommendations for changes. This position stays informed of relevant statutes and applies the requirements of the Colorado Revised Statutes to the work unit. The position also works in collaboration with the Colorado Mental Health Hospitals in Pueblo as well as Fort Logan, the Mental Health Transitional Living program (MHTL), the Division of Regional Centers (DRC), and the Forensic Services Division to develop, draft, and implement policies and strategies for the admission of patients and the management of clients in community placements.

This position assists with the development of policies and procedures for EPICC and ensures all CNS staff receive training and apply such policies and procedures appropriately. Stakeholder Engagement: At a policy level, the Director collaborates with agencies and programs that interface or interact with the CNS program and/or services. This may include proactive outreach to establish shared communications and processes as well as supportive problem-solving and conflict resolution on behalf of (and in partnership with) the team's supervisors.

The Director may create and facilitate stakeholder training specific to CNS, may participate in legislative workgroups upon request, and may be asked to represent the department during court hearings either via subpoena or leadership. The Director is expected to serve as a subject matter expert on behalf of CNS when required. Data Analysis and Reporting: The Director develops and maintains processes for the statistical tracking, monitoring, and analysis of a variety of client- and outcome- specific measures associated with CNS.

The Director prepares and presents current data on a regular basis, serves as the subject matter expert on that data, and may be asked to collect and present additional data as needed. The Director continuously analyzes the data gathered in order to identify trends, anticipate needs, and propose solutions. Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights Experience Only: Nine (9) years of relevant experience in development, implementation, and administrative oversight of behavioral healthcare programs in a management role which includes areas of competency as identified below: Strategic planning Policy creation and implementation Program development and implementation Program monitoring, oversight, and auditing Work unit leadership and management Knowledge of Social Services systems Knowledge of inpatient mental healthcare systems Ensuring service quality and meeting the needs of the clients/patients, community, and referral sources Providing outreach, training, and representation to stakeholders within a variety of contexts including forensic as well as judicial.

Or Education and Experience: A combination of related education in psychology, social work, counseling, healthcare administration, healthcare management, public / government / healthcare policy, or other mental health / healthcare related field and/or relevant experience in development, implementation, and administrative oversight of behavioral healthcare programs in a management role which includes areas of competency as identified below equal to nine (9) years: Strategic planning Policy creation and implementation Program development and implementation Program monitoring, oversight, and auditing Work unit leadership and management Knowledge of Social Services systems Knowledge of inpatient mental healthcare systems Ensuring service quality and meeting the needs of the clients/patients, community, and referral sources Providing outreach, training, and representation to stakeholders within a variety of contexts including forensic as well as judicial. Preferred Qualifications: 3 years of experience in program development and implementation 3 years of experience in program oversight and administration Program evaluation and auditing experience Program policy creation and development experience Behavioral health systems knowledge Behavioral health risk management and mitigation experience Public, Non-profit, and/or Government program administration Experience working in inpatient, locked, detention, and/or forensic clinical settings Knowledge of Medicaid/Medicare benefits systems Knowledge of State benefits systems, especially related to individuals with ID/IDD, neurological, and neurocognitive diagnoses Management of multiple work units or initiatives Demonstrated skill and experience in leading and supporting collaborative teams and teamwork Exemplary verbal and written communication skills Self-directed Resourceful Superior critical and analytical thinking skills Ability to shift focus and juggle multiple priorities Ability to develop and maintain strategic partnerships to ensure the satisfaction of contractual agreements and the achievement of program requirements Experience representing an employing agency in high stakes, high profile situations like legislative initiatives, task forces, courtroom appearances, and media. Ability to align teams across systems Performance management and experience with identifying and working to attain key performance indicators / metrics Experience analyzing and operationalizing legislative as well as statutory rules and guidelines Demonstrated skill and experience managing multiple projects Conditions of Employment: Full background check and reference check required This position requires State of Colorado residency at the time of application (unless otherwise identified in the posting), and residency within the state throughout the duration of employment in this position.

TB testing and flu vaccinations are required. Any other vaccinations or testing that is required by CDHS. Former State employees who were disciplinarily terminated or resigned in lieu of termination must: Disclose that information on the application.

Explain why the prior termination or resignation should not disqualify you from the current position. Provide your employee number from your prior State employment. Absent extraordinary circumstances, prior disciplinary termination or resignation in lieu of termination and failure to provide this information will disqualify the applicant from future State employment with CDHS.

CDHS Selection Process Explanation Employment history is calculated on a full-time basis (40/hrs per week). Part-time employment is calculated on a prorated basis to determine qualifications. Be sure your application specifically addresses your qualifications, experience, work products, and accomplishments as they relate to the position and minimum requirements.

Preferred Qualifications & Competencies: Relevant years of state service experience. Minimum Qualification Screening Process A Human Resources Analyst will review the work experience/job duties sections of the online job application to determine whether your experience meets the minimum qualifications for the position. You must complete the official State of Colorado online appli...