PAR Administrator

Pre-Admission Review (PAR) Administrator

PAR Services

Reports to : Director of PAR Services

Under the general supervision of the Director of PAR Services, the Pre-Admission Review (PAR)– Administrator will provide oversight of the DWIHN PAR Services Department. This position will create, direct, and implement the policies and procedures of the PAR Services Department and provide daily management of PAR Services operations.

Provides oversight of operations and staff for DWIHN Pre-Admission Review Department.

Develops and maintains policies and procedures.

Oversees the DWIHN PAR Services quality assurance program.

Ensures that the assessments, processes, service authorizations and overall service provisions comply and meet DWIHN-PIHP / CMHSP, MDHHS, 42CFR and Mental Health Code requirements.

Ensures and documents that direct clinical supervision is provided.

Ensures that behavioral health services are provided as specified in the treatment plan and coordinated with other care services.

Ensures that the assessment, diagnosis, and treatment of individuals with co-occurring disorders is provided by appropriately trained and qualified clinical staff and that the clinical supervision of such staff is provided.

Participates in the identification of quality care indicators and outcome objectives.

Oversees the collection and review of data to monitor staff and program performance, monitor performance indicators.

Monitors overall clinical care and quality work, in collaboration with DWIHN’s Quality and Compliance Department.

Collaborates with the Chief Medical Officer / Psychiatrist of Direct Services.

Directs and coordinates medical activities and activities related to patient care.

Assesses current mental health programs including restructuring existing programs and developing new programs.

Ensures medical necessity criteria for provided services are met.

Prepares and presents reports to the DWIHN Board of Directors.

Maintains staff calendars including managing staff schedules and availability.

Monitors key performance indicators.

Provides support and coordination for mental health, substance use disorder, and co-occurring services.

Coordinates with PIHP departments.

Serves on DWIHN’s interdisciplinary team.

Identifies opportunities for growth and development for DWIHN PAR Services.

Assists with grant applications.

Attends public speaking, townhall, and community outreach events occasionally serving as the speaker at these events.

Assesses and participates in staff education activities and provides consultation to facility personnel.

Conduct daily business in Director’s absence.

24 / 7 availability on call.

Operationalize vision of department.

Performs related duties as assigned.

Knowledge, Skills And Abilities (ksa’s)

• Knowledge of DWIHN policies, procedures, and practices.
• Knowledge of the DWIHN provider network and community resources.
• Knowledge of the Michigan Mental Health Code.
• Knowledge of MDHHS policies, rules, regulations, and procedures.
• Knowledge of Federal policies, rules, regulations, and procedures as it relates to DWIHN.
• Knowledge of Behavioral Healthcare management principles and practices.
• Knowledge of diverse treatment modalities, therapeutic intervention, evidenced based practices and diagnostic principles.
• Knowledge of MHWIN.
• Knowledge of the LOCUS model.
• Knowledge of oversight of Crisis Services.
• Knowledge of oversight of clinical operations for a large behavioral health operation.
• Knowledge of the clinical care process (screening, assessment, treatment planning, case management, and continuing care).
• Knowledge of and ability to use screening and assessment tools for behavioral health services.
• Knowledge of the continuum of care for persons diagnosed with mental illness, substance use, and serious emotional disturbance.
• Knowledge of Integrated Care services for behavioral health patients.
• Knowledge of Utilization Management practices and principles.
• Knowledge of managed care practices and principles.
• Knowledge of Evidence Based Practices for the behavioral health field.
• Knowledge of and ability to use treatment planning, case management and continuing care for behavioral health services.
• Knowledge of Medicaid, local, regional and national codes, laws and regulations.
• Knowledge of medical and behavioral health practices and terminology.
• Knowledge of compliance standards.
• Knowledge of Medical Necessity Criteria for Behavioral Health Services.
• Knowledge of the American Society of Addiction Medicine Patient Placement Criteria (ASAM).
• Knowledge of the Federal Confidentiality Regulations, 42 CFR, Part 2.
• Knowledge of Medicaid / Block Grant eligibility requirements.
• Knowledge of documents / regulations that govern the provision of mental health services, e.g., Medicaid Manual Mental Health and Substance Abuse Chapter III, State Plan for Medicaid, Michigan Department of Health and Human Services Quality Plan, and the Mental Health Code.
• Knowledge of the practices and principles of psychological, emotional, and sociological assessment and diagnosis.
• Knowledge of the identification and treatment of co-occurring mental health and substance use disorders.
• Knowledge of regulatory and industry best practice standards.
• Knowledge of Community Mental Health Services Programs (CMHSP) and Prepaid Inpatient Health Plans (PIHP)
• Knowledge of Integrated Care methodology, practice, and implementation.
• Knowledge of Quality Management and Quality Improvement principles and practices.
• Knowledge of HEDIS measures and standards.
• Supervisory skills.
• Management skills.
• Leadership skills.
• Administration skills
• Training skills.
• People management skills.
• Assessment skills.
• Evaluation skills.
• Organizational skills.
• Planning skills.
• Time Management skills.
• Report writing skills.
• Problem Solving skills.
• Decision Making skills.
• Critical Thinking skills.
• Interpersonal skills.
• Customer Service skills.
• Communication skills.
• Collaboration skills.
• Active Listening skills.
• Implementation skills.
• Accuracy and detailed oriented skills.
• Computer skills (Word, Excel, Access, Power Point, Outlook, Teams).
• Teamwork Skills.
• Ability to communicate orally.
• Ability to communicate in writing.
• Ability to work effectively with others.
• Ability to work with an ethnically, linguistically, culturally, economically, and socially diverse population.
• Judgement / Reasoning ability.

Required Education

A Master’s Degree from a recognized college or university in the Human Services Field, social services, psychology, counseling, social work, or a related field.

Required Experience

Four (4) years of professional clinical experience in a behavioral healthcare or mental health setting.

AND

At least one (1) year of experience as an executive, manager, administrator or supervisor in a behavioral healthcare or mental health setting.

Required License(s)

A valid state of Michigan clinical licensure : LMSW, LLMSW, LMHC, LPC, LLPC, LLP or PhD.

A valid state of Michigan drivers license with a safe and acceptable driving record.

Working Conditions

Work is usually performed in an office setting but requires the employee to drive to different sites throughout Wayne County and the state of Michigan.

This description is not intended to be a complete statement of job content, rather to act as a general description of the essential functions performed. Management retains the discretion to add or change the position at any time.

Please note : DWIHN requires proof of being fully vaccinated for COVID-19 as a condition of employment. Medical or religious accommodation or other exemptions that may be required by law, will be approved when properly supported. Further information will be provided during the recruitment process.

Detroit Wayne Integrated Health Network is an Equal Opportunity Employer.

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