Vice President Of Clinical Operations

Detroit Wayne Integrated Health Network

Vice President of Clinical Operations

General Summary:

The DWIHN Vice President of Clinical Operations reports to the CEO and provides executive leadership and strategic direction for all clinical service. This position ensures high-quality, person-centered, evidence-based care is delivered across the provider network in compliance with federal, state, and contractual requirements. The VP will oversee clinical program development, utilization management, care coordination, quality improvement, and provider performance, ensuring integration across physical and behavioral health services. This position, in collaboration with the Chief Medical Director, oversees the development, implementation and monitoring of initiatives to assure a high quality of clinical service delivery throughout the DWIHN system. The Vice President of Clinical Operations leads, co-leads, and or informs DWIHN activities that: establish models of practice that are effective and efficient; assess and improve the service capacity of the system; assure well-trained and competent clinicians deliver services within the system; identifies and procures funding resources to support the development and delivery of clinical services.

Duties and Responsibilities:

Consistent with the principles of recovery, members and community focus, best practice models and data-driven decision making the Vice President of Clinical Operations principal responsibilities are as follows:

• Promote and direct activities that align and support the CEO in achieving the goals of the DWIHN's Strategic Plan
• Develop and implement policies and practical procedures that lead to Systems Transformation
• Lead activities that ensure the development, training and implementation of policies, procedures and monitoring of clinical service delivery
• Oversee implementation of evidence-based practices (EBPs), clinical guidelines, and culturally responsive care.
• Supervise the Associate Vice Presidents and Directors of Clinical Departments & Services, ensuring compliance with Federal, State and local contractual requirements in this area, and sustaining funding for its initiatives, including but not limited to Home Community Based Services (HCBS), Habilitation Supports Waiver (HSW) program, Children's Waiver Program (CWP), and Serious Emotional Disturbances (SED) Waiver.
• Develop, lead and strategically prioritize the trainings and conference offerings provided by DWIHN.
• Provide technical assistance and education to the provider network regarding workforce development, and delivering clinical services efficiently and effectively
• Support network development and provider engagement through clinical consultation and performance management.
• Ensure clinical technical assistance and corrective action plans are provided to underperforming providers.
• Monitor provider adherence to medical necessity, documentation standards, and compliance requirements.
• Attend local and state meetings representing DWIHN in the relevant arenas
• Assist in the assessment of at-risk workforce and service gaps, and development of plans for improvement
• Participate in the assessment of system capacity and aggressively pursue system innovations, grants, etc. to meet the community needs
• Work closely with the Chief Medical Director to develop and maintain relationships with universities and other educational/training facilities, serving as the DWIHN liaison to those institutions
• Deliver community education and solicit member and community input in the appropriate areas of expertise
• Oversee and advance grantsmanship
• Lead cross-functional integration of behavioral health with primary care, physical health, housing, crisis services, and justice systems.
• Support care transitions, high-risk case reviews, and complex case management interventions.
• Attend and participate in meetings and work on quality improvement activities as required
• Ensure compliance with Medicaid, CMS, NCQA, HEDIS, state PIHP/CMHSP requirements, and accreditation standards
• Serve as a member of committees as requested
• Remain abreast of the state of the art, laws, policies and the like as related to the delivery of behavioral health services
• Comply with DWIHN, local state and national rules and regulations
• Further the mission of DWIHN through active support of the strategic goals
• Supervision of staff as assigned
• Further duties as assigned

Knowledge, Skills and Abilities (KSA's):

• Ability to effectively lead a team and to share responsibilities and duties.
• Ability to resolve interpersonal conflict in a straightforward and timely manner.
• High level of comfort in working with a cross section of physical and behavioral health care providers, residential providers and staff, school personnel, politicians, membersand their supports etc. using a consultative style.
• Ability to design and implement clinical pathways and protocols for treatment of various behavioral conditions including; mental health, intellectual-developmental disabilities, substance use disorders and co-occurring conditions.
• Ability to train and teach effective behavioral health interventions and the primary behavioral health model.
• Ability to exercise balanced judgment in evaluating situations and making decisions, and to handle difficult or confrontational situations in a calm, consistent and equitable manner.
• Ability to effectively represent DWIHN interests in the community and maintain effective working relationships among coworkers, public, private and professional groups.
• Knowledge of behavioral medicine and evidence-based treatments for medical and behavioral health conditions.
• Knowledge of the workings of the Michigan Department of Health & Human Services (MDHHS), and academic institutions, in order to access funds for research and programming.
• Openness to the emerging workforce in community mental health, including people with lived experience, their family members, allies and fictive kin.
• Knowledge of and work experience with providing services and support to individuals with behavioral health issues.
• Knowledge of Medicaid, managed care regulations, clinical operations, and behavioral health best practices.
• Knowledge of current national and state best practices, initiatives, and policy in the behavioral health field required.
• Must have excellent communication skills, including written and verbal performance.

Qualifications:

Experience

• Ten years of experience working with limited resource population in a managed care environment. Recent Michigan Community Mental Health experience preferred.
• Ten years of recent experience working in administration, operations, program development, provider network management or related areas in healthcare organizations.
• Five years of recent experience directly supervising licensed and non-licensed clinical staff operations and service delivery.
• Successful administration and management of grantsmanship and/or Request for Proposals (RFP) process within the last three (3) years.
• Research in healthcare fields preferred, preferably in behavioral services.

Education and Credentials:

• Master's degree in Social Work, Psychology, Nursing, or related human services fields. (Bachelors in Nursing will suffice especially with an additional Masters in Health Administration or similar field)
• Current state licensure as a Licensed Clinical Social Worker, Licensed Clinical Professional Counselor, Psychologist (Full or Limited Licensed), Registered Nurse or related credentials.
• Meets criteria as a Michigan QMHP.
• Maintain licensure and certifications

Working Conditions:

Work is performed in an office setting, as well as in the field/at provider sites and training venues, as may be indicated.

The above statements are intended to describe the general nature and level of work being performed by person assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.