Clinical Director
Kepro, United States

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. Kepro is seeking resumes for a highly experienced professional.

Summary Description

The Clinical Director will manage and oversee all program activities and compliance. Responsibilities will include supervision of a team of licensed clinicians and administrative support staff to ensure accurate and quality outcomes. This position reports to the Executive Director and includes providing day-to-day oversight of the program’s completion of remote and onsite clinical assessments and determinations. These assessments are provided throughout the state of Illinois to individuals requiring nursing home level of care.

Accountabilities

• Directs program to ensure accurate PASRR evaluations through accurate clinical assessment of the patient, relevant records and collateral sources of individuals.
• Directs program to ensure accurate PASRR review completion by determining appropriate level of care based on the patient’s physical, behavioral, and psychological functioning.
• Effectively directs program through objectives and goals assigned for contract compliance. Monitors metrics and daily operations to ensure success.
• Collaborates with program leaders, including medical director, management teams, and corporate support teams to improve processes, determine training needs and improvement opportunities.
• Responds to state inquiries regarding any PASRR activities.
• Oversees budget review and analysis to ensure the financial success of the program.
• Understands and keeps up with current literature, regulations and research related to long term care, mental illness, intellectual disabilities, medical conditions and geriatrics.
• Provides training, technical assistance, and clinical support to staff, providers, and customers. Statewide training of nursing facility and hospital providers, state staff, and internal staff/field evaluators.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Qualifications

• Registered Nurse, licensed in the state of Illinois, Licensed Clinical Social Worker, Licensed Clinical Psychologist, Nurse Practitioner or other qualified Licensed Mental Health Professional approved by state PASRR authority.
• Graduation from an accredited College with relevant Degree Program.

Knowledge, Skills, Abilities

• Knowledge of Federal Regulation 42 CFR, Chapter 483 and state PASRR rule, 471 NAC 12.
• Knowledge of Medicaid programs with relevant experience navigating similar complex projects.
• Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in Illinois.
• Knowledge of standards of practice related to determination of Level of Care.
• Knowledge of standards of practice related to mental health, geriatric and other disorders typically requiring long term care placement.
• Knowledge and understanding of public sector services and supports.
• Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
• Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.
• Ability to utilize computer equipment and web based software to conduct work.
• Ability to interact with various office staff as needed to support necessary workflows.
• Ability to interact with healthcare professionals, patients, their families and other supports.
• Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
• Assesses and analyzes psychological, emotional, behavioral and physical functioning.
• Develops level of care recommendations based upon clinical evaluations.

Experience

• Minimum experience of five (5) years managing and/or working with Medicaid, government health plans, or PASRR programs is required.

Mental and Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact

Job Rewards and Benefits