Clinical Operations Manager

The Clinical Operations Manager (COM) is responsible for providing prospective clients requesting services with a comprehensive and professional intake experience by assessing the client’s presenting problem and, if appropriate, guiding them to the most appropriate JFS staff or program. The COM will also provide information and referral for resources to meet the needs of callers if JFS is unable to meet their needs. This position will provide credentialing services to clinical staff in the Clinical Services Department. This is an operational position that oversees the Clinical Receptionist, Medical Billing Specialist, and manage medical records request delegation or handling. This position reports to the Director of Clinical Services.

Duties and Responsibilities:

General Intake:

• Intake Phone Calls: talking with individuals seeking therapy, getting them on the waitlist, assessing acuity, type of therapist, other needs, program assignment, etc. 3-4 hours per day, 4 days per week on the phone.
• Answer calls in a professional manner and provide a positive intake experience for clients; answer live and respond to client needs throughout the day, schedule follow-up calls at convenience of clients to assist with their schedules.
• Determine need(s) and assign to the relevant JFS staff or program.
• Determine ability to serve and make appropriate referrals, as appropriate, to external resources.

Clinical Intake:

• If the call is for mental health services, gather the necessary information and follow procedures for Clinical Intake. Conducts intake assessments.
• Contextualize client issues within social and systemic frameworks.
• Ensure warm handoff to ongoing providers.
• Monitor intake capacity and waitlist management.
• Gather information necessary to determine assignment of clinician based on presenting problem and insurance eligibility; enter information into Procentive and schedule intake appointment.
• Verify insurance eligibility (and sliding fee scale eligibility, if appropriate) and refer to Medical Billing Specialist to obtain authorizations.
• Make appropriate recommendations to community resources to potential clinical clients.

CCS

• Ensure all impaneled CCS staff are billing appropriately; utilize Avatar in assisting management of CCS clients, and operationalize referrals to appropriate sources for CCS.
• Complete CCS supervision logs each month.
• Submit supervision logs to the county (Justice – Youth, Lindsay – Adult) by the 15th of the following month; future state will involve uploading to HealthStream.

Records Management:

• Manage all medical records requests, including responding to those requests in a timely manner and consulting about all clinical issues related to records.
• Adhere to and ensure clinic adherence to all HIPAA rules and regulations, as well as office decorum and compliance.

Data Management:

• Work with Agency data professionals to provide any necessary reporting or program information as needed for grants, internal calculations, productivity reporting, or other.
• Produce monthly productivity/performance reports for clinician and clinic to submit to Clinical Services Director
• Maintain intake statistics data and submit regular reports to Director
• Monitor that notes are entered in Avatar within 72 business hours following client contact.
• Run “Notes in Draft” report monthly and ensure staff finalize any draft notes.
• Check referrals in Avatar.
• Keep Smart Sheet up to date for add/drop/availability.

Operational Duties:

• Upload and monitor Orientation Training logs.
• Monitor completion of Annual Training Logs and ensure they are uploaded to HealthStream by January 10 each year; send reminders and monitor staff completion.
• Manage coverage and provide back-up coverage to Clinical Receptionists at the front desk, as needed.
• Attend biweekly Clinical Operations meeting and monthly Clinical Services Department meeting.

Medical Billing

• Address issues related to medical billing on a regular basis
• Oversight of Medical Billing Specialist and credentialing process

Other:

• Additional duties and responsibilities as assigned.

Bachelor’s degree in Human Services, Business, (or related field), preferred, and 2 years of experience working in a clinic setting and/or with individuals with mental health disabilities.

Proficient in Microsoft Office application suite with demonstrated skill in Excel and Word, required. 

Previous experience with Electronic Health Records preferred. Previous experience with Procentive and Avatar helpful. (Procentive is an Electronic Health Record utilized for scheduling, billing (for insurance and grants), and reporting data across the clinic. Avatar NX is a Milwaukee County BHD Electronic Health Record utilized for CCS clients within the clinic. It is used for managing patient services, clinical documentation and billing through the county.)

Knowledge of Revenue Cycle Management

Previous experience providing credentialing services within a clinical setting preferred.

Familiarity with local community-based resources for individuals, families, and older adults, especially those living in poverty or struggling with mental health issues.

Other desired qualities include: highly organized, attention to detail, flexible, self-directed, ability to prioritize work, ability to support a large staff and excellent communication, written and oral, and exceptional interpersonal skills.

Ability to work effectively with clients, consultants, department/agency staff and other team members.

Ability to pass a criminal background check with the Wisconsin Department of Justice and a caregiver background check with the Wisconsin Department of Health Services, the Department of Children and Families and the Department Safety and Professional Services.

Knowledge, understanding and/or willingness to learn Jewish culture and traditions necessary.