Utilization Management Supervisor (PPM III)

King County • 401 5th Avenue - Seattle, WA

2d • Hybrid

About The Position

King County's Department of Community and Human Services (DCHS) is seeking a Hospital and Mental Health Residential (HMHR) Treatment Utilization Management Supervisor (Project/Program Manager III). This position is responsible for the overall utilization management operations of the Hospital & Mental Health Residential Treatment Team. The Supervisor will lead a team of Mental Health (MH) Care Authorizers who ensure King County residents accessing MH residential care and other high-intensity MH programs receive the appropriate level of care, services, and support for recovery. The role involves participating in the BHRD Utilization Management Committee and leading quality assurance activities such as site visits, contract compliance reviews, and invoice reconciliation.

Requirements

• Master's Degree in Social Work, Psychology, Behavioral Science, or related field with independent license.
• Mental Health Professional as defined in WAC 246-341-0200 and RCW 71.05.020.
• Demonstrated leadership skills to include leading daily operations, supporting care-transition decision-making, and promoting collaboration across departments to optimize resource utilization and patient movement.
• Experience working with publicly funded behavioral health service systems.
• Knowledge of issues related to mental health residential treatment facilities.
• Knowledge of and experience with psychiatric hospital discharge planning services and scope of services provided within the facilities.
• Demonstrated ability to work effectively with a broad range of constituents, including consumers, social services and housing providers, volunteers, government officials, community members, boards, high-level management, elected officials, advocates, government and agency staff, and others.
• Excellent verbal and written communication skills.
• Experience gathering and utilizing data and generating reports for system improvements and for presentations to management staff and others.
• Demonstrated ability to simultaneously manage multiple tasks/projects in detail and meet deadlines.
• Computer skills; knowledge of MS Outlook, Word, PowerPoint, and Excel.
• Must be able to pass a criminal background check on a pre hire/post offer basis.

Nice To Haves

• Two years recent supervisory experience in mental health setting, preferably mental health residential treatment, Utilization Management or Quality Assurance.
• Two years of recent demonstrated contract management experience, including but not limited to invoice reconciliation, data entry, data validation, and independent quality assurance reviews.
• Knowledge of utilization management strategies and quality management practices.
• Knowledge or experience with ECLS, PDAMS, HMIS.

Responsibilities

• Lead a team of MH Care Authorizers to ensure King County residents accessing MH Residential care and other high intensity MH programs receive the appropriate level of care and services, and support for stepping down to lower levels of care.
• Participate as a key member of the BHRD Utilization Management Committee.
• Lead quality assurance activities, including site visits of mental health residential treatment providers, contract compliance reviews, invoice reconciliation, and other monitoring activities.
• Lead quality improvement activities focused on oversight of high intensity mental health services, flow between levels of care, and utilization management/care coordination efficiencies.
• Complete and direct continuing stay reviews to determine if an individual meets medical necessity standards using the Level of Care Utilization System (LOCUS) Assessment.
• Supervise and monitor Mental Health Utilization Project-Program Manager II staff.
• Lead the collection, analysis, and reporting of utilization and care-transition data to ensure timely progression of care, appropriate resource use, and optimal patient throughput.
• Develop coordination, partnership, and communication within the Behavioral Health and Recovery Division (BHRD) and other DCHS Departments.
• Ensure continuing stay reviews meet Utilization Management Timelines established by BHRD’s Quality team and Managed Care Organizations (MCOs).
• Communicate outcomes of continuing stay reviews with supervisors of mental health residential facilities contracted through the King County Integrated Care Network (KCICN).
• Develop and maintain excellent working relationships with behavioral health providers in the mental health residential treatment continuum.
• Align workflow of the Utilization Management Team to promote equity and social justice, and a recovery-oriented system of care, with the goal of facilitating transition from psychiatric hospitalization.
• Attend and participate in assigned meetings, treatment conferences, and committees relevant to job functions.
• Troubleshoot, advocate, and resolve issues between community members, behavioral health housing providers, or governmental organizations.
• Participate as part of the Hospital and Mental Health Residential Treatment (HMHR) Section Leadership Team.
• Perform other related duties as assigned.

Benefits

• County-issued laptop provided.
• Home workspace with internet connection required for remote work.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager