Must Live in Louisiana To Qualify For Consideration

The Supervisor, Behavioral Health Chart Monitoring is responsible for leading and coordinating contractual statutory reporting requirements for ACLA behavioral health). The Supervisor, Behavioral Health Chart Monitoring will supervise a team of Behavioral Health Chart Monitoring Specialists, behavioral health provider quality monitoring reviewers, oversee, coordinate and conduct behavioral health and Applied Behavioral Analysis (ABA) provider quality monitoring reviews, adverse incident reviews / reporting and monitor fidelity and outcomes for Evidenced Based Practices. The position will also be responsible for collaborating with a multidisciplinary team to ensure the member’s needs are assessed and addressed in a timely manner based on the results of the LDH Behavioral Health Member Survey and organizing plans to address strategies for increasing outcome measures and deficiencies identified in LDH’s Behavioral Health.

• Communicates and collaborates with providers, state agencies, contracted Louisiana Medicaid managed care organizations and national organization representatives as necessary.
• Assures minimally necessary treatment records are collected and organized for clinical reviews to occur.
• Summarizes all findings for review by clinical committees as appropriate.
• Prepares and generates results letters and/or Corrective Action Plans and report results quarterly.
• Tracks trend and investigates adverse incidents submitted by providers for state reporting.
• Maintains a database to support trending and reporting of adverse outcomes resulting from clinical care provided.
• Develops reports and analysis for semi-annual trending reports and presents to the Quality of Clinical Care Committee (QCCC), Quality and Performance Improvement (QAPI), and Quality of Service Committee (QSC) for input and direction. Follows up on any recommendations.
• Maintains policies including annual reviews, updates, and approvals.
• Maintains documentation in accordance with contractual requirements.
• Quarterly Inter-Rater Reliability is conducted for both behavioral health and ABA.
• Quarterly training on provider quality monitoring tools.
• Monitors work progress to ensure that deadlines are met and that quality standards are upheld.
• Trains new employees on provider quality monitoring review procedures, tools, and related processes.
• Reviews employee performance to determine whether they are meeting standards or making improvements.
• Provides guidance and support to employees in their work teams to ensure that they are performing their jobs effectively.
• Monitors and reports on employee productivity to ensure that goals are being met.
• Collaborate with other departments to provide behavioral health data collected for their departmental statutory and regulatory reporting.
• Participates in meetings at a minimum of twice weekly with the MCOs awarded the contract by LDH to streamline and standardize provider quality monitoring review processes across MCOs and decrease provider abrasion.
• Evaluates and recommend alternative auditing procedures to the Provider Quality Monitoring Program (PQMP) MCO group for continuous improvement.

Education/ Experience:

• Master’s prepared and must hold one of the following licensures: LMHP – Licensed Mental Health Professionals, LCSW-Licensed Clinical Social Workers; LPC- Licensed Professional Counselors; LMFT-Licensed Marriage and Family therapists; LAC-Licensed Addiction Counselors.
• 3-5 years proven leadership experience in the clinical practice of Behavioral Health required
• Minimum of 3 years in clinical or service quality improvement required
• Minimum of 3 years in healthcare delivery required
• Proficient with Microsoft Office applications including Word, PowerPoint, Excel required
• Knowledge of Medicaid and Medicare highly preferred