Director, Social Work and Ambulatory Services

Beth Israel Lahey Health•Lynn, MA

About The Position

The Director of Social Work and Ambulatory Services reports to the Executive Director of Inpatient Behavioral Health and ensures quality patient care by developing and maintaining standards of care across social work, admissions, groups, outpatient, utilization management, and the partial hospital program. The Director establishes and maintains systems for effective, timely communication with patients, families, collaterals, referral sources, community agencies, and payors. The role provides leadership to social workers, clinicians, and ambulatory services staff in support of effective, efficient, high-quality care and aftercare planning. In collaboration with the senior leadership team, the Director provides guidance and direction for social work, utilization management, aftercare planning, administrative and staffing management, communication and collaboration, professional development and orientation, quality improvement, and financial management. The Director oversees utilization review for the inpatient behavioral health division and interfaces with external payors to determine medical necessity for admissions and continued hospitalization. The role also partners with other departments, community agencies, vendors, and payors.

Requirements

Master’s degree in social work (MSW).
Current Massachusetts Licensed Independent Clinical Social Worker (LICSW) license.
Minimum 5 years of experience in an inpatient behavioral health setting.
Minimum 3 years of managerial experience.

Nice To Haves

Prior experience in healthcare admissions.

Responsibilities

Direct and ensure high-quality inpatient social work services and aftercare planning that meet state and regulatory requirements.
Develop, implement, and maintain revenue-generating strategies related to admissions and patient capacity.
Plan, monitor, and manage department budgets, and manage staffing within budgetary guidelines across social work, admissions, groups, outpatient, utilization management, and the partial hospital program.
Oversee utilization management and appeals, and understand behavioral health payment requirements, including 340B.
Develop and implement general, emergency, and program-specific policies and procedures to support a safe, productive, and therapeutic program and comply with hospital, regulatory, and accrediting standards.
Collaborate with group leaders to create, evaluate, and periodically update group programming.
Ensure the outpatient department meets productivity goals and documentation standards.
Stay apprised of federal and state regulations governing capacity, billing, and reimbursement, including Medicaid and Medicare guidelines, and Joint Commission standards.
Ensure the partial hospital program and outpatient department meet licensing and regulatory requirements.
Provide supervision to department managers.
Network and collaborate with stakeholders.
Provide clinical consultation and oversight of case planning.
Hire, develop, train, and manage the performance of staff.
Oversee student contracts for master's-level interns.
Provide back-up coverage to the Human Rights Officer and perform service recovery.
Ensure systems support effective and timely communication with patients, families, collaterals, referral sources, community agencies, and payors.
Interface with external payors to determine medical necessity for admissions and continued hospitalization.
Partner with other departments, community agencies, vendors, and payors.