Entry Level Provider Network Development Jobs in Detroit, MI

Agency Name: Detroit Wayne Integrated Health Network

Position Type: Part Time

Salary Range: $185.00 per Hour

Under the supervision of the Chief Medical Officer, the Psychiatrist will help develop Evidence Based Best Practice Standards for service delivery and perform other clinical duties and activities as directed.

Principal Duties And Responsibilities:

• Provides direct clinical/patient care duties and responsibilities as required, including psychiatric evaluation, re-evaluation, disposition, coordination of medical services with nurse on duty, medication orders/prescribing, restraint orders, monitoring patients, etc.
• Incorporates Evidenced Based Best Practice Standards into service delivery.
• Provides care compliant with licensing regulations and accreditation standards.
• Provides expertise on medical topics such as psychotropic medication, psychiatric evaluation, coordination of care, etc.
• Supervises coordination of care activities.
• Oversees discharge planning.
• Completes clinical documentation.
• Oversees and provides clinical supervision to Advanced Practice Providers; collaborates, discusses cases, and co-signs notes.
• Provides supervision and direction to the mobile crisis team.
• Completes doctor-to-doctor communications.
• Reviews Eligibility assessments for members contacting the Crisis Care Center.
• Provides oversight for the following: utilization management/review; denial of services, appeals; retrospective reviews; reporting and review of deaths; reporting and review of sentinel events; and clinical aspects of Medicaid Fair Hearings.
• Determines medical necessity and conducts peer review which can include on-site consultations with contractors and service providers.
• Oversees policy development.
• Researches medical topics such as psychotropic medication, psychiatric evaluation, and coordination of care, etc.
• Engages in publication opportunities.
• Meets with Medicaid Health Plans (MHP) to coordinate integration of services.
• Provides training specific to the application of medical necessity criteria for all referrals to the Network's program for comprehensive mental health services.
• Conducts staff development and training for Medical Directors, providers, Network staff, and other professional staff.
• Serves in a leadership capacity for the following committees: Medical Advisory, Utilization Management, Peer Review, Sentinel Events, Death Review, Behavioral Treatment Advisory Committee, Credentialing Committee, and others as required or directed by the Chief Medical Officer.
• Provides consultation on cases in Emergency Departments, Inpatient psychiatric units, State hospitals or those receiving services through our providers.
• Provides clinical reviews for all cases requiring psychiatric consultation for the Recipient Rights office.
• Teaches Psychiatric residents and fellows.
• Participates in clinical and administrative meetings.
• Oversees the extended length of stays, long-term hospital transfers, discharge planning and annual community hospital surveys.
• Participates in Quality Assurance reviews.
• Consults with the Quality Management Department to provide continuous quality improvement of services delivered to our members, contractors, and providers.
• Consults with the Quality Management Department to provide internal quality improvement.
• Analyzes and evaluates patient data.
• Provides consultations for Disability Designation of members.
• Reviews Eligibility assessments for members contacting the Access Center.
• Provides clinical coverage and consultation on any urgent clinical issue that may arise between the time that members contact the Access center and until they are seen by our Clinically Responsible Service Providers.
• Teaches students and Psychiatry residents and fellows.
• Participates in clinical and administrative meetings.
• Participates in Quality Assurance reviews.
• Initiates and/or continues emergency medication orders or restraints in accordance with state law.
• Collaborates with an interdisciplinary team to continuously improve productivity, efficiency, recovery outcomes, and medical care.
• Ensures appropriate responses to all medical emergencies.
• Provides clinical coverage and consultation on any urgent clinical issue that may arise between the time that members contact the Crisis Care Center and/or Mobile Crisis Team and until they are seen by our Clinically Responsible Service Providers.
• Attends shift handover meetings.
• Identifies and timely reports any health and safety risks, accidents, incidents, injuries, and property damage at the workplace.
• Performs related duties as assigned.

Knowledge, Skills And Abilities (Ksas):

• Knowledge and experience with the Accreditation and Certification Standards Joint Commission.
• Knowledge of DWIHN policies, procedures, and practices.
• Knowledge of the DWIHN provider network and community resources.
• Knowledge of the Michigan Mental Health Code.
• Knowledge of MDHHS policies, rules, regulations, and procedures.
• Knowledge of Federal policies, rules, regulations and procedures as it relates to DWIHN.
• Knowledge of the clinical care process (screening, assessment, treatment planning, case management, and continuing care).
• Knowledge of and ability to use screening and assessment tools for behavioral health services.
• Knowledge of medical and behavioral health practices and terminology.
• Knowledge of compliance standards.
• Knowledge of Medical Necessity Criteria for Behavioral Health Services.
• Knowledge of documents / regulations that govern the provision of mental health services, e.g., Medicaid Manual Mental Health and Substance Abuse Chapter III, State Plan for Medicaid, Michigan Department of Health and Human Services Quality Plan, BBA requirements and the Mental Health Code.
• Knowledge of the practices and principles of psychological, emotional, and sociological assessment and diagnosis.
• Knowledge of diagnostics, psychopharmacology, and supportive treatment approaches as applied to a severely mentally ill (SMI) adult population.
• Knowledge of the identification and treatment of co-occurring mental health and substance use disorders.
• Knowledge of psychotropic medications.
• Knowledge of Community Mental Health Services Programs (CMHSP) and Prepaid Inpatient Health Plans (PIHP)
• Knowledge of community mental health services and resources.
• Knowledge of the DSM-IV Statistical Manual.
• Leadership skills.
• Training skills.
• Assessment and evaluation skills.
• Organizational skills.
• Planning skills.
• Analytical skills.
• Report writing skills.
• Decision Making skills.
• Critical Thinking skills.
• Interpersonal skills.
• Communication skills.
• Teaching skills.
• Written communication skills.
• Computer skills (Word, Excel, Access, Power Point, Outlook, Teams)
• Teamwork Skills.
• Ability to communicate orally.
• Ability to communicate in writing.
• Ability to work effectively with others.
• Ability to work with an ethnically, linguistically, culturally, economically and socially diverse population.
• Judgement/Reasoning ability.

Required Education:

• A Medical Degree from an accredited School of Medicine. Board Certification in Psychiatry.
• Note: Additional Board certification in Child and Adolescent psychiatry is preferred.

Required Experience:

• Three (3) years of experience in a Mental Health Program with experience in the following areas:
• policy writing
• accreditation activities
• staff development
• peer review management of direct report staff

Required License(s):

• A valid and current Michigan License to practice as a physician.
• A valid and current Michigan controlled substance license.
• Valid and current Drug Enforcement Agency Registration.
• A valid State of Michigan Driver's License with a safe and acceptable driving record.

Special Conditions:

• If not currently Board Certified, should be Board