Insurance Program Manager Jobs in Beaverton, OR (NOW HIRING)

This Job Is Located In Eugene, OR- Relocation is Available

Primary Purpose  

The Outpatient Program Manager’s primary responsibility is to provide competent clinical and administrative supervision to the outpatient and treatment foster care Individual and Family Therapists (IFTs) in our Northern Region (Eugene and Coos Bay), in compliance with regulatory guidelines. As the IFT supervisor, this position is responsible for reviewing clinical documentation and applying co-signatures as needed. The Program Manager is responsible for providing staff training, including but not limited to: Regulatory requirements, quality documentation, specific clinical approaches, and program protocols and procedures. The Program Manager assists the management team in assuring effective utilization of agency services.  This position may also provide comprehensive mental health assessments and maintain a small caseload. Travel to Coos Bay at least once a month will be required for in-person supervision; an agency vehicle will be provided. 

Education and Experience

Must meet Qualified Mental Health Professional (QMHP) classifications, which includes a degree in one of the following:
•    Graduate degree in Psychology
•    Graduate degree in Counseling
•    Graduate degree in Social Work
•    Graduate degree in recreational, art, or music therapy
•    Graduate degree in a behavioral science field or
•    A qualified Mental Health Intern

Must be a Licensed Social Worker, Counselor, Psychologist, or Marriage and Family Therapist within the state of Oregon. Three years’ experience mental health settings with youth and families. Supervisory experience is preferred.
Must demonstrate the ability to conduct an assessment, including identifying precipitating events, gathering histories of mental and physical health, substance abuse, past mental health services and criminal justice contacts, assessing family, cultural, social and work relationships, conducting a mental status examination, complete a DSM diagnosis, write and supervise the implementation of a Service Plan, and provide individual, family or group therapy within the scope of their training.

Minimum Qualifications

• Provide proof of current, valid Oregon Driver’s License (or if out-of-state will obtain Oregon license within 30 days), comprehensive automobile insurance (if applicable) and a safe driving record (minimum of 3 yrs.) to use company or personal vehicle for required duties.
• Successfully pass a Criminal Background Check and Medicaid Fraud Check.
• Obtain and maintain current certification in the Child and Adolescent Needs and Strengths (CANS) assessment.
• Obtain and maintain current Crisis Prevention Intervention (CPI) Certification and demonstrate proficiency in CPI Certification procedures.
• Obtain and maintain current First Aid and Cardiopulmonary Resuscitation (CPR) certification.

Essential Duties, Responsibilities and Core Competencies

• Provide clinical supervision to the IFTs using Feedback Informed Treatment (FIT) case review approach.
• Participate in rotating on call responsibilities for treatment foster care.
• Assure timely production of agency-wide, uniform collaborative clinical documentation in coordination with Program Managers to comply with all regulatory and contractual requirements.
• Consistently meet program billing requirements.
• Responsible for developing and managing performance of IFT’s to ensure program is meeting the needs of youth, families, and our contracts.
• Identify, define, and develop solutions for problems related to utilization of prescribed services, processes, or procedures.
• Maintain awareness of service configuration, access procedures and service availability.
• Review services provided to determine medical necessity and to promote the most efficient use of available.
• Demonstrate knowledge of all applicable Oregon Administrative Rules (OAR) and Behavior Rehabilitation Services Rules as they pertain to assessment tools and service plans. 
• Demonstrate knowledge of and be able to efficiently access community resources, support services, and referral systems for treatment and discharge planning.
• Review services provided and documentation to ensure compliance with both public and private entities’ reimbursement policies for continued services.
• Monitor provision of care from the beginning.
• Decide whether care is appropriate and necessary before it has been rendered and provide immediate feedback to the clinician.
• Act as a resource for staff on regulations and policies and procedures as they pertain to each youth’s service plan.
• Identify and review potential cases of fraud, abuse, or mis-utilization and refer to Program Manager for further investigation.
• Conduct Critical Incident Debriefings as necessary.
• Training

 Clinical and Administrative Supervision of Individual and Family Therapists 

• Provide extra training and support to the IFT’s with direction from the Program Managers.
• Provide additional specific training for agency staff as directed from the Community Services Director, Clinical Director, or Program Managers.
• Provide required new hire trainings as requested. 
  Administrative Duties
• Promote positive staff relations through communication and implementation of agency policies, procedures, and practice guidelines.
• Delegate tasks and responsibilities to assure smooth team function and task completion.
• Demonstrate a high level of competence and problem-solving skills in risk management, evidence-based therapeutic interventions, and decision making while considering impact on youth and young adults, staff and other departments.
• Working knowledge and ability to utilize, reference, and follow agency policies, procedures, and guidelines to provide immediate action in daily responsibilities.
• Assist in development and maintenance of agency policies and procedures as they pertain to clinical supervision and utilization management.
• Identify opportunities for improvement of clinical practice in the program as well as agency and program practices based on research and best practice information; communicate opportunities to the applicable supervisor.
• Participate in continuous quality improvement and assurance activities.
• Abide by ethical codes, mission, values, and professional standards, including confidentiality.
• Actively utilize and reference agency policies, procedures, and guidelines.
• Present a positive attitude, professional demeanor and demonstrated respect with youth and young adults, families, staff, visitors, and community partners.
• Perform all work tasks in a proper and safe manner per established policies, procedures, and guidelines to prevent unnecessary injury, time loss and agency expense.
• Comply with all federal, state and agency health and safety reporting requirements.
• Complete direct supervisee performance evaluations in accordance with Kairos policy.
• Regularly create, review, and submit IFT productivity reports.
• Participate in program reviews and quality assurance assessments.
• Serve as back up to the Program Manager Assistant Program Manager.

Other Duties

• Perform other related work as assigned.
• Attend trainings and meetings as assigned. May be appointed to committees. 

Attendance

• Maintain prompt and regular attendance in accordance with company policy.
• Ability to be flexible and adjust schedule as necessary to fit program needs and meet the needs of youth and their families.

Physical Demands: The physical demands described here are representative of those that must be met by the staff person to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the staff person is regularly required to use hands to type, handle, reach with hands and arms, talk or hear. The staff person frequently is required to stand and walk. The staff person is occasionally required to sit, stoop, kneel, crouch or crawl. The staff person must frequently lift and or move up to 10 pounds and occasionally lift and/or move up to 45 pounds.  Specific vision abilities required for this job include close vision, distance vision, and depth perception and operating a motor vehicle.

Working Conditions: The working conditions described here are representative of those that must be met by the staff person to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the staff person is frequently exposed to loud noises, outside weather conditions such as heat, cold and humidity.  The staff person is occasionally exposed to chemical solutions and body fluids. 

Hazardous Conditions: Risk of verbal and physical threats and harm from clients. Possible exposure to air and Bloodborne Pathogens.

Equipment Used: May include general office equipment, such as computer, telephone, agency or personal vehicle, general cleaning supplies, and kitchen utensils/supplies.

Travel: Travel is expected for required training and supervision.

Other Responsibilities: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required for this job. Duties, responsibilities, and activities may change at any time with or without notice.

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