Medical Policy Manager jobs in Canton, OH

Safe Harbor Ohio exists to provide restorative care to child survivors of sex trafficking creating environments that spur healing and growth and surround them with therapeutic and spiritual services so they can thrive.

SUMMARY: The Medical Manager works under the direction of the Residential Director to provide medical management for residents. The Medical Manager is responsible for the partnership and oversight of SpringVale Health Centers. This includes, but is not limited to medical, dental, optical, and other appointments, MAR/medication administration, triage of medical complaints/concerns. Works in conjunction with the Intake Coordinator to ensure a smooth transition into CRC program regarding medication management and needed medical follow up. This may be through direct care, Community Psychiatric Supportive Treatment (CPST) activities, group, or individually. Works to coordinate wellness activities in conjunction with the Program Manager.

This position provides management of SpringVale Health Centers clinical and administrative practices in behavioral health programming. They will lead the multidisciplinary teams to provide high-quality therapeutic services to each resident, establish and nurture community clinical and medical relations. The Medical Manager will have on-call duties and be accessible onsite or face-to-face via interactive video conferencing based on the youth's medical needs.

ESSENTIAL DUTIES & RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

It is the responsibility of each employee to be a consistent witness for Jesus Christ and to adhere to the Statement of Faith/Standard of Moral Conduct. Further, each employee is responsible for dealing with others with a Christ-like attitude while helping them experience their worth in Christ and demonstrating behaviors reflecting relentless commitment, selflessness, and kindness.

Job-specific essential functions include the following:

• TEAM FIRST: Makes every effort to maintain a 'team first' spirit and atmosphere within the workplace environment, maintaining appropriate working relationships and promoting collaboration.

Direct Client Care to include, but not limited to:

• Orders, receives and distributes routine and Over the Counter (OTC) medications for all residential treatment units within established guidelines.
• Coordinates services with pharmacy, Community Support Provider (CSP), therapist, or other persons involved in clients' treatment. Communicates med changes obtaining requires permissions from guardians and insurance companies.
• Develop and maintain acceptable professional practice standards through supervision, planning, evaluation, and study of developments and trends in behavioral health.
• Supervise all therapeutic programs and participate in and contribute to the agency's development of programs.
• Provide direct supervision and management of SpringVale Health Centers staff.
• Maintain accurate and confidential records including the ongoing management of the electronic health record system.
• Ensure all activities within Safe Harbor Ohio are conducted within the guidelines and regulation of federal HIPAA requirements.
• Develop and track individual and group therapy hours, individualized treatment goals as needed for each girl.
• Assists with medical message line by documenting messages, returning phone calls, and returning necessary phone calls.
• Pulls charts, checks for needed documentation updates, prepares med som notes/forms to prepare for doctor appointments:
  • Provides on-call services as established.
  • Maintains MARS per established guidelines.
  • Keeps Carelogic system updated with current residential client medications.
  • Performs random med checks as needed.
  • Reviews MARS on a regular basis to ensure compliance.
  • Coordinates change of medication form with appropriate county.
• Coordinates medical appointments and coordinates transportation as needed.
  • Maintains medical records, documentation and tracking of medical appointments, including but not limited to annual, follow ups and initial appointments.
  • Communicates outcomes to placing entities and others as appropriate.
• Verifies any lab work received and/or outstanding orders and communicates with cottage staff about pending appointments or outstanding results.
• Oversees and maintains stocking of first aid kits in each cottage, cottage cars, and staff medical packs.
• Provides education to client regarding medication management, side effects and the importance of nutrition/hygiene. Engages team in wellness activities for residents.
• Maintains MARs for each resident ensuring side effects sheets, doctor's orders, and other documentation according to ODJFS guidelines and CCHO/Safe Harbor Ohio policies and procedures.
• Manages and tracks discontinued medications following guidelines for discarding discontinued medications.
• Completes Critical Incident Reports when directly involved with resident.
• Triages injury/illness as needed for more extensive medical care per approved guidelines.
• Works in conjunction with the Psychiatrist and other licensed providers to ensure medical needs/care are provided to residents.

Other duties may be assigned.

SUPERVISORY RESPONSIBILITIES: Oversees SpringVale Health Centers and Case Management.

REQUIRED SKILLS & ABILITIES:

• Ability to effectively present information in one-on-one and small group situations.
• Ability to use medical terms as related to youth mental health and psychiatric care. Ability to write treatment plans, progress notes and all other necessary mental health paperwork for clients' charts.
• Ability to read lab reports, prescriptions, and doctor's orders. Ability to understand, monitor and communicate units of measure for prescription medications.
• Ability to problem solve with clients and advocate for them with their doctor.
• Excellent interpersonal skills, including conflict resolution, required. Must be able to communicate well with colleagues, verbally and in writing to ensure safety and efficiency.
• Ability to apply common sense, understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
• Excellent organizational skills and attention to detail.
• Competency with Microsoft Office Suite and the internet, as well Safe Harbor Ohio's clinical documentation software (electronic health record).
• Thorough knowledge of the policies and procedures of Safe Harbor and ODJFS Minimum Standards for Residential Treatment Facilities.
• Demonstrated competence and consistent implementation of the core components of our treatment program. Ensure the implementation of each resident's treatment plan; to ensure the completion of required documentation for each resident and to provide leadership to the members of the clinical team.
• Ability to prioritize and respond to the children and staff's needs; to effectively use time to ensure assigned tasks are completed within designated time frames.
• Ability to work cooperatively and productively with supervisor, subordinates, co-workers, and volunteers; to work effectively; to maintain professional relationships; to resolve conflicts appropriately and use the proper chain of command when communicating. Ability to demonstrate advanced leadership skills in working with children and coworkers.
• Ability to provide constructive and specific feedback professionally that demonstrates the concept for change and gives examples and suggestions to the employee receiving the feedback.
• Ability to grow professionally and learn new skills; to accept constructive feedback and modify behavior accordingly.
• Ability to lead others in working in a stressful and sometimes unpredictable environment; skill in handling crisis situations without overreaction or loss of objectivity.
• Ability and willingness to understand, incorporate, and practice new theoretical perspective treatment strategies.

EDUCATION, EXPERIENCE, CERTIFICATIONS/LICENSES:

• RN, LPN or Certified Medical Assistant.
• Has extensive knowledge of trauma-focused therapies.
• At least three years of experience providing direct clinical services to children with emotional disorders, with at least one year in a residential treatment setting, including counseling and assessment (internship and practicum experiences may be credited toward this requirement for recently licensed professionals).
• Familiarity with Trust-Based Relational Intervention (TBRI).
• Crisis management experience; demonstrates ability to assess needs, manage crisis, and when appropriate, refer to internal or community mental health resources.
• Experience or training in providing services to survivors of complex trauma and/or trafficking.
• Strong interpersonal skills with the ability to be compassionate and firm and always maintain confidentiality.
• Knowledge of community resources.
• Excellent organization and planning skills.
• Position requires driving in personal vehicle and/or agency vehicle to include freeways and highways to satellite offices, offsite meetings, and events as needed.
• Must be able to work on a flexible schedule as needed to meet work, program, and project deadlines.
• Must be able to obtain a valid Ohio driver's license and have a safe driving record.
• Be able to pass a drug screening and obtain clear background checks, tuberculosis test or chest X-ray.

PHYSICAL REQUIREMENTS:

• Frequently required to walk, sit, talk, and hear, including a requirement to stand or walk for extended periods of time, sometimes through uneven terrain.
• Often required to use hands/fingers, handle or feel; reach with hands and arms, climb or balance and stoop, kneel, crouch or crawl. Specific vision abilities required include close vision, distance vision, depth perception, and the ability to adjust focus.
• Prolonged sitting at a desk or workstation and working on a computer.
• Ability to use a telephone, hear and be heard, and speak clearly with clients and the general public. Must be able to use a cell phone.
• Regularly able to lift/move up to 50 pounds.
• Specific vision abilities required by this job include close vision, distance vision, depth perception and ability to adjust focus.
• Must be able to drive a vehicle legally and safely in the state of Ohio.
• Must maintain compliance/certification with CCHO/Safe Harbor's requirements for using physical restraints (SCM: Safe Crisis Management), including sufficient strength and completion of extensive training. Physical ability to respond to crisis, including, but not limited to running and performing physical restraints.

CONTINUOUS QUALITY IMPROVEMENT (CQI): All Safe Harbor Ohio staff are expected to focus on Quality improvement as a part of their job responsibilities, in an effort to make Safe Harbor Ohio a safe and healing environment for clients and staff. This expectation includes, but is not limited to teamwork, improving service delivery, fulfilling department goals, and other job-specific tasks that encourage excellence.