CLINICAL PROGRAM MANAGER

UHS•Palm Springs, CA

About The Position

Michael’s House provides comprehensive, evidence-based, integrated inpatient treatment for addiction and co-occurring mental health conditions. Its approach includes individually tailored treatment plans, group and individual therapy, psychiatric and medical follow-up, trauma resolution, and emphasis on social skills, wellness, and holistic recovery. The Clinical Program Manager will lead the outpatient team in providing individualized patient care in a welcoming, recovery-focused environment. The role calls for a collaborative leader who supports and develops clinicians, builds trust with clients and families, and promotes evidence-based treatment. The position oversees clinical operations and workflows, staff training and competencies, program quality, patient interactions, utilization management activities, documentation, audits, and appeals. The manager also supports staff development and retention and works with patients, families, stakeholders, and facility departments to resolve issues and improve care.

Requirements

Minimum of 1–3 years’ experience working in a substance dual-diagnosis facility with client contact.
Minimum of 1–3 years’ experience working in a managed care position.
Minimum State of California licensure as LPC, LMFT, LCSW, LLMSW, or Registered Nurse.

Nice To Haves

Master’s degree in psychology, MFT, social work, or a related field is preferred.

Responsibilities

Create and manage operational workflows within Clinical Services and across the facility, overseeing day-to-day operations.
Provide training and monitor clinical skill competencies within Clinical Services.
Ensure clinically appropriate programming and patient interactions are in place and followed within the clinic and across departments.
Meet with patients, stakeholders, and family members to resolve issues and provide direct patient care as needed.
Identify opportunities for facility improvement and lead or participate in change initiatives.
Complete continued-stay reviews with external review agencies as indicated and as needed.
Maintain Utilization Management files and logs in a neat, accurate, and orderly manner.
Provide the clinical team with feedback regarding documentation, medical necessity criteria, and patient benefits.
Provide timely notification of denials and maintain accurate MIDAS entries and reports.
Advocate on behalf of patients and the facility.
Prioritize and coordinate daily Utilization Management workload, ensure appropriate staffing levels, and cover staff caseloads as needed.
Review cases involving days that were not authorized to determine appeal options.
Conduct routine chart audits or audits as indicated.
Collaborate with the Business Office to coordinate the appeals process, write appeal letters, and process appeals in a timely manner.
Provide documentation training to new or current employees as needed.
Promote a positive work environment, encourage staff development, and provide timely, meaningful recognition to support job satisfaction and retention.
Understand and adhere to the facility’s Professional Boundary standards and policy.
Meet all assigned annual competency requirements.
Perform other duties as assigned.