Clinical Analyst

Oakland Community Health Network•Troy, MI

6h•Hybrid

About The Position

The Clinical Analyst participates as a Clinical Practice Team member. Guides clinical services delivery and implements OCHN’s strategic vision and plan with the respective Providers within the Service Network, including initiatives and projects that advance involvement of persons served, quality outcomes, performance improvement, cost analysis, evidence-based practices and contract compliance. Essential Functions Under general direction and as assigned: Provide clinical content expertise and guidance to the Provider / Service Network for the development and improvement of service initiatives, projects, and programs. This includes conducting research, obtaining community input, analyzing data and developing reports, etc. Implement / monitor Best / Evidence-Based Practice models of service, including protocol and policy development / improvement and monitoring of adherence to fidelity guidelines. Promote alignment with OCHN clinical protocols and practice guidelines through conducting audits and facilitating performance improvement activities. Create system change through implementation of the principles and practices of Recovery, Self-Determination, Trauma-Informed Systems, Person / Family Centered Planning, Zero Suicide Initiatives and other Best Practices, including the evaluation of outcomes and satisfaction of individuals served. Conduct in-depth clinical case reviews and make recommendations. Develop Utilization Management guidelines, policies, practices, and outcomes; analyze utilization data including identifying age and population-specific trends; provide written reports / analysis to administration; make recommendations for improvements; and provide training / education, as needed. Take a leadership role in monitoring the effectiveness of clinical activities, identify improvement actions, as necessary, and make recommendations to administration. Identify, participate in the development of, and ensure the implementation of appropriate training within OCHN, its provider network, and the community to ensure that staff have the necessary skills to advance OCHN’s strategic plan. This may include being the OCHN system lead trainer for certain practices (ex: LOCUS, DLA-20, etc.). Participate in workgroups and committees with other OCHN Teams, such as involvement in Access, Quality Management, Service Network Teams, SUD Team, benefits coordination initiatives, Zero Suicide initiatives, etc. Actively participate in the development of contracts and performance evaluation for contract continuation, including assessing outcomes, business practices, quality indicators, Customer Service and Recipient Rights trends, etc. Analyze data and develop management reports. Provide recommendations for improvement plans as well as recognition for exemplary practices. Participate in the resolution of systems issues identified by OCHN teams including communicating relevant information, analyzing data / trends, and making recommendations, arranging provider education / training, and ensuring development and evaluation of improvement plans. Participate in the resolution of Provider issues / complaints, including involvement in the Dispute Resolution process and Appeals process. Implement identified initiatives and projects via participation in local, state, and federal collaborative activities. Provide clinical oversight for intensive services such as admissions to community hospitals and State Facilities, including continued stays, and transition / discharge planning. Complete daily incident report (IR) reviews. Participate in and present IR reviews weekly at the Sentinel Event Review Committee (SERC). Conduct Sentinel Event clinical reviews in accordance with OCHN policy. Perform other duties as assigned.

Requirements

Master's degree in mental health field with a full unrestricted license.
State of Michigan licenses, certification and / or registrations as Psychologist (LLP, LP), Social Worker (LMSW), Counselor (LPC), or Marriage and Family Therapist (LMFT).
Minimum of 5 years relevant experience in providing services to Individual’s with Intellectual / Developmental Disabilities or Adults with Mental Illness and/or persons with substance use / co-occurring disorders and/or experience with Children with Serious Emotional Disturbance may be considered.
Demonstrated effective interpersonal skills.
Demonstrated ability to work effectively in a team environment.
Demonstrated effective negotiation skills.
Demonstrated effective written and oral communication skills.
Demonstrated effective computer skills.
Demonstrated Leadership Skills.
Knowledge of the Michigan Mental Health Code and Medicaid Provider Manual.
Understanding of Medicaid rules and regulations.
Understanding of utilization management.
Must have available means of transportation to and from OCHN and for required offsite meetings or site visits.
Must be available for meetings and events which may occur outside of standard office hours.
The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation.

Nice To Haves

Preference for experience in providing clinical services in the public sector.
Preference for experience in human services administration, contract management, or related area in the public sector.
Demonstrated experience in quality assurance and quality monitoring.
Demonstrated experience in the preparation and monitoring of budgets.
Demonstrated experience in data analysis, report writing and outcome measurement.
Demonstrated understanding of the person / family centered planning process and commitment to honoring the choice of individuals served by OCHN and its provider network.
Knowledge of Health Care Systems desired.

Responsibilities

Provide clinical content expertise and guidance to the Provider / Service Network for the development and improvement of service initiatives, projects, and programs.
Implement / monitor Best / Evidence-Based Practice models of service, including protocol and policy development / improvement and monitoring of adherence to fidelity guidelines.
Promote alignment with OCHN clinical protocols and practice guidelines through conducting audits and facilitating performance improvement activities.
Create system change through implementation of the principles and practices of Recovery, Self-Determination, Trauma-Informed Systems, Person / Family Centered Planning, Zero Suicide Initiatives and other Best Practices, including the evaluation of outcomes and satisfaction of individuals served.
Conduct in-depth clinical case reviews and make recommendations.
Develop Utilization Management guidelines, policies, practices, and outcomes; analyze utilization data including identifying age and population-specific trends; provide written reports / analysis to administration; make recommendations for improvements; and provide training / education, as needed.
Take a leadership role in monitoring the effectiveness of clinical activities, identify improvement actions, as necessary, and make recommendations to administration.
Identify, participate in the development of, and ensure the implementation of appropriate training within OCHN, its provider network, and the community to ensure that staff have the necessary skills to advance OCHN’s strategic plan.
Participate in workgroups and committees with other OCHN Teams
Actively participate in the development of contracts and performance evaluation for contract continuation
Analyze data and develop management reports.
Participate in the resolution of systems issues identified by OCHN teams
Participate in the resolution of Provider issues / complaints
Implement identified initiatives and projects via participation in local, state, and federal collaborative activities.
Provide clinical oversight for intensive services such as admissions to community hospitals and State Facilities, including continued stays, and transition / discharge planning.
Complete daily incident report (IR) reviews.
Perform other duties as assigned.