GENERAL SUMMARY OF POSITION:

Under the general supervision of the Director or designee, DES Program Manager is responsible for planning and managing a large support unit whose functions involve providing clinical staff and medical professionals direct support of activities required to complete disability determination process for a number of client agencies in one or more states, as well as other new lines of business that DES may develop in the future. The incumbent is also responsible for ensuring compliance with DES guidelines and state and state and federal regulations governing the disability determination process and privacy of protected health information.

MAJOR RESPONSIBILITIES:

Manage the day to day administrative operations of the unit to ensure that staff provides clinicians with the required support to enable medical and psychological determinations to be conducted with complete data and in an efficient, cost effective, and timely manner.
• Develop and monitor guidelines for the effective support by staff of the activities of medical and psychology professionals in the disability review process.
• Manage DES programs related to unit functions and process. Provide input during the program initiation or renewal process.
• Provides administrative support for existing and new DES lines of business through sound management of unit processes.
• In collaboration with administrative managers, provide direction for the unit's customer service operations through monitoring and measuring unit call volume, promoting positive customer service telephone skills, developing telephone coverage schedules, reviewing and revising client letters, and monitoring staff customer service performance.
• Analyze and evaluate existing administrative systems, identify opportunities for systems improvements and increased efficiencies, and implement these improvements in coordination with all impacted units.
• Collaborate with DES Senior Management to provide administrative analysis of clinical support and administrative resources required to pursue new business opportunities and to establish clinical support and administrative procedures for new business programs brought into productions.
• Develop and monitor guidelines for determinations that do not require clinical decisions.
• Foster and environment of continuous quality improvement and staff participation in quality improvement workgroups both within the unit and in collaboration with other DES units.
• Promote the privacy of protected health information within the unit through knowledge of HIPAA and other privacy and data security laws, staff education, and training. Coordinate data security issues and training with the DES Compliance Liaison and the ForHealth Consulting Office of Compliance and Review.
• Oversee and provide human resource support in the areas of unit staffing, recruitment, counseling, compensation, and benefits. Insure all personal action activity related to hiring, firing, performance measurement, contracting, and funding is completed.
• May serve as liaison with external organizations and other departments.
• Adhere to University, State, and funding agency regulations.
• Perform related duties as needed and as assigned.
• Perform Quality Assurance reviews on administrative staff and report findings and trends to the Associate Director of Clinical Operations or designee.
• Communicate and implement policy, workflow and organizational changes to all direct reports.

REQUIRED QUALIFICATIONS:

• RN - Registered Professional Nurse, with current unrestricted license with six years of relevant experience, or equivalent clinical licensure and experience.

OR

Masters prepared licensed or certified vocational rehabilitation counselor or other licensed or certified Allied Health professional with 3 years of relevant experience in the medical and/or Psychological fields including two years of specific medical training

PREFERRED QUALIFICATIONS:

• Supervisory experience in oversight of staff and processes, including staff providing support to the clinical function of physicians and psychologists, as well as office management or other administrative positions with specific knowledge of customer service, computer report preparation, and quality improvement.
• Experience in process improvement or other quality improvement activities.
• Demonstrated communication skills, both oral and written necessary to interact with clients, Agency partners, and staff.
• Demonstrated experience in using computer-based tools including electronic mail, word processing, data base management, spreadsheets and graphics.
• Understanding of state and federal laws and regulations related to disability or disability determination.
• Understanding of state and federal laws and regulations related to privacy and security of protected health information and data in a medical setting.