State Director, Social Work & Behavioral Health

InnovAge•San Bernardino, CA

About The Position

Assumes responsibility for Behavioral Health and Social Work operations across the Centers and the state or region assigned. Collaborates with the VP of Behavioral Health to ensure the implementation of behavioral and mental health program, applicable clinical supervision, and assessing the effectiveness of the behavioral and mental health program across applicable Centers. Ensures the efficiency and effectiveness of the Social Work model to promote service delivery and compliance with PACE regulations and performance measures. Establishes, develops or ensures adoption of best practices, innovations, performance and production metrics and expectations, documentation standards for the Social Work and BH staff to promote high functioning teams. This position in collaboration with the VP of Behavioral Health and Center Triads, is responsible for ensuring the achievement of performance goals by Center and across the assigned state or market to include: quality, compliance, and customer service within the Program of All-inclusive Care for the Elderly (PACE) product. Essential Functions and Work Responsibilities Functional Category: Oversight and Management Estimated Percent of time Spent – 60% Develops, adopts and ensures adherence to performance outcomes and measurements that focus on commitment, achievement, performance improvement, and the use of best practices to ensure Center and state or regional quality and compliance goals are met or exceeded. Ensure collaboration with the Interdisciplinary Team to support delivery of care and services to participants through interventions to achieve outcomes as identified in the care plan. Standardizes processes among teams and across Centers in the applicable state or market and in accordance with company standards where available. In collaboration with Compliance, VP of Behavioral Health, and Triads and in response to process variation and internal/external audit results, develops and implements templated approaches to guide social work and behavioral health staff in addressing and documenting IDT needs including but not limited to complex participant rounds; high-risk participant rounds; family/participant meetings and unique participant needs resulting from family violence; transitions of care; housing instability and homelessness; unmanaged behavioral health concerns; catastrophic conditions, and others. Oversees operational aspects of direct behavioral health/mental health services made available to participants. Evaluates and manages the overall effectiveness of the social work and behavioral/mental health program by implementing change and quality improvements as needed, based on observation, reports, performance outcomes and statistical analysis. Ensure cross-training of LCSW staff to fulfill the regulatory requirements related to social work including but not limited to initial and ongoing assessments and care plans and related documentation, Service Delivery Requests, and Grievances to improve the participant experience for participants whose behavioral health condition (s) create barriers to communication and engagement. Assesses the effectiveness of existing Social Work and Behavioral Health policies, procedures, and desk aides/standard operating procedures and revises or develops and implements refined or new policies and procedures as needed. Monitors compliance with all applicable licensing, certification and accreditation requirements. Works collaboratively with the VP of BH, clinical teams, and Triads to address aberrant utilization patterns through interventions, innovations, and other solutions. Serves as a member on various committees both within and outside of the organization as requested. Manages and facilitates auditing activity of participant records to ensure timeliness and completeness of documentation, assessments, care plan activities, and contacts to ensure a comprehensive and compliant medical record is in place for all participants. Provides expertise to support the training of social work and the mental health specialists in collaboration with the VP of Behavioral Health. Supports Functional Category: Supervision Estimated Percent of time Spent – 35% Encourages team building by coaching and mentoring staff as needed. Lead by example and provide motivation and direction on a consistent basis. Carries out management responsibilities in accordance with the organization's policies and applicable state and federal employment laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; recognizing and rewarding employees; corrective disciplinary procedures and practices (under direction of supervisor and in partnership with Human Resources), addressing complaints and resolving problems. Ensures annual employee performance reviews are conducted in a timely and effective manner. Evaluates performance of employees for compliance with established policies and objectives of the organization and contributions in attaining objectives. Helps set the tone to ensure morale, teamwork, and that the positive employment culture of the organization is maintained. Regularly schedules leadership/management5, department, and staff meetings to provide leadership, development, and a forum for communication to ensure coordination and collaboration in meeting organization and individual goals. Functional Category: Budgeting and Financial Estimated Percent of time Spent – 5% Assists in the development of annual budgets for the departments and assists with overall budget process and financial objectives. Monitors expenditures with commitment to good stewardship of the organization’s resources. Develops relationships to support participant care and services with external stakeholders and community agencies. Additional work functions and duties may be assigned.

Requirements

Master’s degree in Social Work, Behavioral Health or Registered Nurse
Unrestricted license as an LCSW, LPC, PhD, PsyD or RN
A minimum of 10 years total related experience.
A minimum of 7 years in a managed healthcare setting with at least five (5) years clinical management experience of large, integrated social work and behavioral health team.
A minimum of 5 years supervisory or management experience
A minimum of 3 years’ experience working with the frail or elderly is required.
Strong understanding of Medicare, Medicaid, managed long-term service and supports programs and principles, health care quality outcomes and associated metrics.
At least two years’ experience working in a highly matrixed organization.
Demonstrated experience in the utilization of data analytics to inform decision making, improve quality, increase customer satisfaction.

Responsibilities

Develops, adopts and ensures adherence to performance outcomes and measurements that focus on commitment, achievement, performance improvement, and the use of best practices to ensure Center and state or regional quality and compliance goals are met or exceeded.
Ensure collaboration with the Interdisciplinary Team to support delivery of care and services to participants through interventions to achieve outcomes as identified in the care plan.
Standardizes processes among teams and across Centers in the applicable state or market and in accordance with company standards where available.
In collaboration with Compliance, VP of Behavioral Health, and Triads and in response to process variation and internal/external audit results, develops and implements templated approaches to guide social work and behavioral health staff in addressing and documenting IDT needs including but not limited to complex participant rounds; high-risk participant rounds; family/participant meetings and unique participant needs resulting from family violence; transitions of care; housing instability and homelessness; unmanaged behavioral health concerns; catastrophic conditions, and others.
Oversees operational aspects of direct behavioral health/mental health services made available to participants.
Evaluates and manages the overall effectiveness of the social work and behavioral/mental health program by implementing change and quality improvements as needed, based on observation, reports, performance outcomes and statistical analysis.
Ensure cross-training of LCSW staff to fulfill the regulatory requirements related to social work including but not limited to initial and ongoing assessments and care plans and related documentation, Service Delivery Requests, and Grievances to improve the participant experience for participants whose behavioral health condition (s) create barriers to communication and engagement.
Assesses the effectiveness of existing Social Work and Behavioral Health policies, procedures, and desk aides/standard operating procedures and revises or develops and implements refined or new policies and procedures as needed.
Monitors compliance with all applicable licensing, certification and accreditation requirements.
Works collaboratively with the VP of BH, clinical teams, and Triads to address aberrant utilization patterns through interventions, innovations, and other solutions.
Serves as a member on various committees both within and outside of the organization as requested.
Manages and facilitates auditing activity of participant records to ensure timeliness and completeness of documentation, assessments, care plan activities, and contacts to ensure a comprehensive and compliant medical record is in place for all participants.
Provides expertise to support the training of social work and the mental health specialists in collaboration with the VP of Behavioral Health.
Encourages team building by coaching and mentoring staff as needed.
Lead by example and provide motivation and direction on a consistent basis.
Carries out management responsibilities in accordance with the organization's policies and applicable state and federal employment laws.
Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; recognizing and rewarding employees; corrective disciplinary procedures and practices (under direction of supervisor and in partnership with Human Resources), addressing complaints and resolving problems.
Ensures annual employee performance reviews are conducted in a timely and effective manner. Evaluates performance of employees for compliance with established policies and objectives of the organization and contributions in attaining objectives.
Helps set the tone to ensure morale, teamwork, and that the positive employment culture of the organization is maintained.
Regularly schedules leadership/management5, department, and staff meetings to provide leadership, development, and a forum for communication to ensure coordination and collaboration in meeting organization and individual goals.
Assists in the development of annual budgets for the departments and assists with overall budget process and financial objectives.
Monitors expenditures with commitment to good stewardship of the organization’s resources.
Develops relationships to support participant care and services with external stakeholders and community agencies.