Clinical Care Manager

SAMH - LSF Health Systems
7785 Bay meadows Way
Suite 300
Jacksonville, FL 32256, USA

Lutheran Services Florida (LSF) envisions a world where children are safe, families are strong, and communities are vibrant.

LSF is seeking a talented Clinical Care Manager who wants to make an impact in the lives of others.

Purpose and Impact:

The role of Clinical Care Manager is to implement all utilization management and clinical management functions and to work directly for the Director of Program Operations with tasks assigned. This position is responsible for managing quality within the network of care, including management of higher levels of care within the network as well as involvement in credentialing and subcontractor oversight.

Essential Functions:

• Assists the Director of Program Operations with tasks as assigned.
• Implement a Quality Improvement/Clinical program that is designed to expand, improve, and monitor services for substance abuse and mental health clients in NE FL.
• Implement a continuous quality improvement process throughout the Quality Improvement/Clinical function, focusing on systems/process improvement to better serve both internal and external customers/clients.
• Interpret and administer pertinent federal and state rules, regulations, and statutes in accordance with sound clinical contract management principles.
• Provide direction on technical assistance and training needs of the system of care providers.
• Provide direction on the implementation of Evidence Based Practices throughout the system of care.
• Directs the oversight of critical incidents within the provider network. Develops appropriate strategies for addressing issue of risk management with regards to client care.
• Analyze and compile detailed reports regarding utilization management data, trends and quality improvement needs.
• Participate in clinical determinations, including denials, outlier management, retrospective clinical chart reviews and real-time utilization oversight.
• Participate in addressing the technical assistance and training needs of the system of care providers.
• Participate in the implementation of Evidence Based Practices throughout the system of care.
• Develops relationships and collaborations with contracted providers.
• Provide leadership, direction, and management to all direct reports in order to support and enhance their ongoing development, production, and operation of their departments.
• Participate in the development of the agency’s plans and programs as a strategic partner. Evaluate and advise on the impact of long-range planning, introduction of new programs/strategies and regulatory action.
• Ensure that department staff are trained in and utilizing best practice methods, processes and activities in order to most efficiently and effectively accomplish tasks.
• Participate in statewide conferences and meetings as deemed appropriate.

Other Functions:

Other tasks and duties as assigned.

Physical Requirements:

Energy, persistence and stamina sufficient for functioning as a part of a team in a fast-paced office environment.

Education:

Master’s degree in social work, mental health counseling, psychology or nursing and appropriate state licensure.

Experience:

Three to five years of experience in providing clinical care to vulnerable populations. Experience with both mental health and substance abuse services.

Skills:

Proven ability to analyze and interpret clinical patient information. Knowledge of Evidence Based Interventions. Experience with providing both mental health and substance abuse services to vulnerable populations.

Other:

Must demonstrate sensitivity to our service population’s cultural and socioeconomic characteristics and needs.

Principal Accountabilities:

• Reports to the Director of Program Operations.
• Team player with providers and co-workers.
• Accurate, complete and timely submission of all required reports.
• Cost effective operations.

Why work for LSF?

LSF offers 60 programs across the state of Florida serving a wide range of populations in need.
Mission Driven staff members become part of the LSF community while transforming the lives of those in need. Our staff additionally find growth opportunities as they explore areas of interest…