Keystone Peer Review Organization, Inc. Looking for Behavioral Health Clinical Director (Remote – Virginia) at New York County, New York Full Time

Behavioral Health Clinical Director

• Are you an experienced Behavioral Health Clinical Director looking for a new challenge?
• Do you value care management and quality improvement?
• Are you motivated, energetic, and excited to become part of the Kepro team?

If so, you might be our next new team member!

Who we need:

The Behavioral Health Director will manage and oversee all program activities and compliance. They will manage and supervise experienced, sufficiently trained administrative and clinical staff who can address the unique behavioral health needs of the members while addressing any participating service limitations to assure that services are provided in the most

economical manner. This position reports to the Senior Vice President and includes providing day-to-day oversight of the needs of the behavioral health population served. The Behavioral Health Director shall have experience with utilization review, medical necessity criteria, community mental health services, inpatient levels of care, and children’s residential treatment services.

Why us?

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What you’ll do:

• Directs program to ensure accurate evaluations through accurate clinical assessment of the patient, relevant records, and collateral sources of individuals.
• Directs program to ensure accurate review completion by determining appropriate level of care based on the patient’s physical, behavioral, and psychological functioning.
• Effectively directs program through objectives and goals assigned for contract compliance. Monitors metrics and daily operations to ensure success.
• Collaborates with program leaders, including medical director, management teams, and corporate support teams to improve processes, determine training needs and improvement opportunities.
• Responds to state inquiries regarding any activities.
• Oversees budget review and analysis to ensure the financial success of the program.
• Understands and keeps up with current literature, regulations and research related to long term care, mental illness, intellectual disabilities, medical conditions and geriatrics.
• Provides training, technical assistance, and clinical support to staff, providers, and customers. Statewide training of nursing facility and hospital providers, state staff, and internal staff/field evaluators.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

What you’ll need:

Required Qualifications

• A psychiatrist, physician or other licensed mental health professional licensed in the Commonwealth of Virginia.

Knowledge, Skills, Abilities

• Knowledge of Medicaid programs with relevant experience navigating similar complex projects.
• Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in Virginia.
• Knowledge of standards of practice related to determination of Level of Care.
• Knowledge of standards of practice related to mental health, geriatric and other disorders typically requiring long term care placement.
• Knowledge and understanding of public sector services and supports.
• Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
• Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.
• Ability to utilize computer equipment and web based software to conduct work.
• Ability to interact with various office staff as needed to support necessary workflows.
• Ability to interact with healthcare professionals, patients, their families and other supports.
• Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
• Assesses and analyzes psychological, emotional, behavioral and physical functioning.
• Develops level of care recommendations based upon clinical evaluations.

Experience

• Minimum experience of five (5) years managing and/or working with Medicaid, government health plans and/or programs is required.
• Minimum of five (5) years of experience working with complex behavioral health populations.

Thank You!

We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Kepro Talent Acquisition Team

Mental and Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

EOE AA M/F/Vet/Disability

Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.