Job: Team Leader

Jobing Description

APS Healthcare is a leading provider of specialty healthcare solutions to more than 20 million members in the United States and Puerto Rico. Throughout our diversified client portfolio, APS delivers customized, integrated healthcare solutions that help members engage in behaviors that optimize their health status, make a significant, positive impact on the healthcare system and improve clinical and financial outcomes. Our team has a drive for excellence and we are committed to a common goal in which we all deeply believe: changing healthcare for the good of the clients we serve, their members and the local communities in which we work.

APS Healthcare is growing and we are seeking a proven Team Leader to join our West Virginia team.

Position Summary:
Provides leadership and oversight to Trainer/Consultants to ensure guidelines, policies, procedures and timelines are followed.

Essential Functions:
1. Reviews specific cases and clarify questions with Care Management and Training/Consultation staff and provide oversight of monthly Grand Rounds.
2. Provides input on internal and external training needs related to clinical policies and procedures and based on the analysis of information obtained through provider audits and utilization data analysis.
3. Establishes individualized recommendations for provider technical assistance and training related to clinical practices, based on information obtained through provider audits and utilization data analysis and provide agency specific technical assistance as needed and appropriate.
4. Reviews denials of service for private practitioner psychologists and non-physician rehabilitation services and will conduct desk audits to monitor appropriateness of care and adequacy of provider documentation.

Other Duties:
Participates as needed in refining utilization review and management criteria, the record review process, and policies and procedures as needed for all programs (MNS, SNS, MR/DD Waiver).

Education:
Licensed (WV) Ph.D. or Master s Level Psychologist; or Masters's in Social Work with a WV LGSW or higher level license; or Master Level Counselors with an LPC.

Experience:
Minimum 4-6 years experience in public sector human services or behavioral healthcare field in an outpatient clinical setting.
Minimum 3-4 years management experience required.

Knowledge:
Decision making skills
Prioritization and organizational skills
Customer service orientation with good interpersonal skills

Skills:
Leadership skills
Proficient at Microsoft word and Excel
Excellent clinical assessment skill; strong written and verbal skills

Reasoning Ability:
Critical thinking/problem solving skills