PAY RANGE: EP21
BEHAVIORAL HEALTH CLINICAL CONSULTANT
(Bilingual)
(General)
This is clinical behavioral health program evaluation work for the Network Improvement and Accountability Collaborative (NIAC) unit of the Department of Behavioral Health and Intellectual Disability Services (DBHIDS). Positions allocated to this class perform site visits for all agencies and organizations contracted to provide behavioral health programs and services funded by DBHIDS. Work includes the on-site monitoring, analysis, and evaluation of program operations to assure conformance to DBHIDS Practice Guidelines for behavioral health services, clinical practices, and regulatory requirements for contracted providers. Contact with the representatives of contracted providers, behavioral health professionals, and Departmental administrators are significant aspects of the work. This position is also required to facilitate and coordinate visits on a rotating basis and perform related duties. Work is performed under the guidance of a technical superior.
ALLOCATING FACTORS: (The following conditions must be met for a position to be allocated to this class.)
· Positions in this class must conduct site visits at provider locations to assess the alignment of program operations and clinical outcomes with DBHIDS Practice Guidelines.
· Positions in this class must be located in the Network Improvement and Accountability Collaborative (NIAC) unit of the Department of Behavioral Health and Intellectual Disability Services (DBHIDS).
TYPICAL EXAMPLES OF WORK (ILLUSTRATIVE ONLY)
Bilingual Specialty
Performs the duties shown below with members of the English language speaking and designated non-English language speaking populations.
Both Specialties
Conducts ongoing analysis of behavioral health, intellectual disability services, and/or addiction services program operations and regulations; evaluates provider compliance with federal, state and local requirements, including but not limited to current Pennsylvania Department of Drug & Alcohol Programs, Office of Mental Health, Behavioral Health Special Initiative, Community Behavioral Health, and/or Network Improvement and Accountability Collaborative requirements governing the provision of contracted programs and services.
Performs site visits on a rotating basis, that include, but are not limited to the following activities: auditing clinical and employee files, reviewing policies and procedures, facility tours, Living Reviews, facilitating focus groups with agency personnel and individuals receiving services, and other regulatory requirements; acts on a rotating basis as the lead clinican to both facilitate and coordinate an agency site visit; maintains a portfolio of behavioral health programs assigned for site visits by a technical superior; coordinates related preparation meetings and tasks, including collaboration with other DBHIDS technical personnel to identify specific budgetary, clinical, or other concerns prior to a site visit; identifies and reviews invoices to select clinical records for auditing; collaborates with other participants in a site visit to observe and score criteria for an objective summary of program performance; ensures that reports submitted by contracted providers are cohesive and contain required information; coordinates Entrance and Exit conferences with the representatives of contracted providers to summarize findings and review recommendations.
Gathers, reviews, and analyzes data acquired through site visits; analyzes programs using several sources of data including: agency contract information, clinical documentation, focus groups, interviews with agency personnel and/or individuals receiving services, quantitative data, and policies and procedures; evaluates performance based upon, but not limited to, the following factors: accessibility of care; individualized treatment practices; program atmosphere; integrated services and supports; quality care management; supportive program operations; and quality improvement or evaluation processes implemented internally by the contracted provider.
Evaluates the quality of behavioral health treatment in relation to individual diagnoses, prognoses, recovery plans, and/or resilience plans; analyzes the type and quantity of dispensed behavioral health medications to determine valid use in relation to individual diagnoses and reduce the risk of contraindications; ensures that professional best practices are implemented; determines the overall effectiveness of behavioral health treatment as guided by specific program goals, objectives, and outcomes.
Works with behavioral health professionals and individuals receiving services to determine if clinical progress has been achieved; ascertains appropriate level of care transition, based upon the effectiveness of treatment plans and clinical outcomes; meets with medical professionals to review and discuss metabolic syndrome screening to ensure that screening criteria are accurate and complete.
Prepares, or contributes information for ongoing technical reports to document findings and recommendations about program performance; cites clinical documentation to identify program strengths or areas needing improvement; identifies areas of concern regarding treatment that may require additional review in consultation with DBHIDS physicians and/or psychologists; identifies areas of concern regarding program operations that may require additional review by a technical or administrative superior; coordinates communication between DBHIDS personnel as needed to resolve identified concerns.
Reviews Quality Improvement Plans submitted by contracted providers and performs subsequent monitoring activities as needed; forwards quality assurance concerns to the appropriate DBHIDS personnel and/or external organizations for resolution; identifies potentially fraudulent provider activity by auditing clinical files, analyzing program operations, and conducting focus groups with agency personnel and individuals receiving services.
Performs related work as required.
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES
KNOWLEDGE OF:
· behavioral health therapeutic modalities, diagnostic criteria, treatment approaches, clinical guidelines and best practices
· psychotropic and physical health medications, interactions, contraindications, side effects, and appropriate usages in relation to diagnosis
· professional publications and technical literature including the Diagnostic and Statistical Manual of Mental Disorders DSM-IV and DSM-5
· applicable laws, regulations, and guidelines governing behavioral health disciplines and programs, including Medical Assistance regulations
· principles and practices of administration applicable to promoting and coordinating behavioral health programs in a county-wide jurisdiction
ABILITY TO:
· learn about programs and services that agencies are contracted to provide via funding from DBHIDS
· learn and apply DBHIDS Practice Guidelines
· learn clinical assessment for the Pennsylvania Client Placement Criteria (PCPC) and Adolescent Placement Criteria (ASAM)
· analyze behavioral health programs using multiple sources and types of data
· determine and plan activities needed to collect program data
· coordinate complex scheduling requirements on an ongoing basis
· conduct interviews and facilitate focus groups with diverse participants and audiences
· clearly present clinical and program related information to large groups in public forums
· write and summarize reports in a concise and comprehensive manner
· interpret and apply local, state, and federal laws, regulations, and ordinances
· work independently under minimal supervision in different field locations
· work cooperatively and communicate effectively with individuals, professionals and agencies representing a variety of behavioral health treatment perspectives
· attend regularly scheduled meetings and travel to provider locations, at times outside of Philadelphia County
· express ideas effectively, both orally and in writing
· use standard office equipment and software including Microsoft Excel, Word and PowerPoint in the completion of assignments
MINIMUM ACCEPTABLE TRAINING AND EXPERIENCE (The following statement represents the minimum training and experience standards which will be used to admit or reject applicants for tests. Applications submitted by candidates for this class will be reviewed based on the following training and experience requirements as approved on 3/21.)
EDUCATION:
Completion of a Master’s degree program at an accredited college or university with major coursework in the social or behavioral sciences, education, human development, human services, nursing administration, psychology, social work, public health, public administration, or a related discipline.
AND
GENERAL EXPERIENCE:
Three years of administrative, technical or social work experience in a credentialed or licensed behavioral health organization performing planning, implementation, evaluation and research duties in a behavioral health, addiction services or intellectual disability services program.
AND
SPECIFIC EXPERIENCE:
Option 1
One year of program analysis work at the full performance level including responsibility for planning, developing, monitoring, and evaluating programs that provide services in the following areas: behavioral health, addiction services, or intellectual disability services.
OR
Option 2
One year of provider relations experience focused on client or provider needs in a behavioral health organization with responsibility for managed care operations including customer service, program management and claims administration.
OR
Option 3
Two years of experience managing a behavioral health, addiction, or intellectual disability services program including responsibility for providing and/or overseeing the full provision of care.
OR
Any equivalent combination of education and experience determined to be acceptable by the Office of Human Resources which has included a Master’s degree and the specific experience described above.
NOTE: City of Philadelphia classes that typically meet the minimum acceptable training and experience are:
Public Health Program Analyst (5F72)
ADDITIONAL REQUIREMENT FOR THE BILINGUAL SPECIALTY
Sufficient training and/or experience to be able to understand and speak fluently and clearly in English and the designated non-English language.
PHYSICAL AND MEDICAL REQUIREMENTS
Ability to physically perform the duties and to work in the environmental conditions required of a position in this class.
LICENSES, REGISTRATIONS AND/OR CERTIFICATES
Possession of a valid proper class motor vehicle operator's license, as issued by the Commonwealth of Pennsylvania, prior to appointment and during tenure of employment as a Behavioral Health Clinical Consultant.
Possession of the following background clearances or the ability to obtain them within two months of appointment as a Behavioral Health Clinical Consultant:
1. Pennsylvania Child Abuse History Clearance
2. Federal Bureau of Investigation Criminal Background Check
3. Pennsylvania State Police Criminal Background Check
Class Established: CSC - 11/12; Ad. Board - 12/12
Spec Revision: CSC – 4/14; Ad. Board – 5/14
CSC- 4/15; Ad. Board- 4/15
Spec. Revision: CSC- 1/17; Ad. Board- 2/17
Latest Spec. Revision: CSC- 2/21; Ad. Board- 3/21
JH