Provider Relations Specialist

Provider Relations Specialist

Work closely with the Provider Relations Manager, Clinical Director, Chiefs, and other OCOK departments to build a Provider Network with a healthy capacity and continuum of residential care. Responsible for ensuring the smooth transition of new providers to the OCOK Network. Helps OCOK Network Providers build programs that ensure safety for residents and the use of evidence-based treatment models. Ensure that all 3rd party utilization review reports are reviewed and that any program-specific deficiencies are addressed. Review, analyze, and share OCOK provider performance data with providers to promote and ensure positive outcomes for youth in residential care. Address all program service and treatment issues with providers.

Position includes exposure to parents, guardians, and conservators as well as to youth with behavioral problems, including possible physical aggression. Will be required to travel to attend meetings, training, or conduct business off site. Must have a valid driver's license and meet agency's underwriting standards if driving on agency business. A personal vehicle is required for travel.

The Provider Relations Specialist will have access to confidential records, including youth files, DFPS Residential Child Care Investigations (RCCI) and Health and Human Services Commission (HHSC) Child Care Regulation (CCR) investigations, foster care/adoption records, foster/adopt parent information and biological family history. Must maintain confidentiality and follow policies related to personnel records and client records.

Planning

Coordinates and/or participates in meetings with collaborating partners and agencies.

Participates in other administrative and planning meetings as needed to facilitate referral and placement/

Manages, initiates, and facilitates quality assurance and crisis management meetings both internally and externally.

Implementation

Receives and reviews client information from OCOK, DFPS, Network Providers, and other agencies to ensure the appropriate provision of services to youth placed with an OCOK Network Provider.

Receives and reviews Network Provider policies and processes to ensure the safety of youth and the implementation of safety measures, program model and treatment strategies to ensure that youth are receiving the services they need to heal from trauma and achieve permanency.

Ensures the safety of youth by working collaborating with OCOK Permanency, network providers and other residential settings, not limited to but including hospital, through crisis intervention, development of programs, and monitoring as appropriate.

Reviews and responds to all 3rd party level of care utilization reviews to ensure that OCOK youth are receiving appropriate services based on their needs. Will track, respond to, and encourage Network Provider progress towards best practice.

Monitors and reviews RCCI and CCR investigations for trends of safety concerns and addresses findings with providers to ensure child safety and standard compliance.

Ensures that Network Providers adhere to applicable OCOK policy and procedures and other Contract outcomes.

Maintains an up-to-date listing of all Agency network providers and services.

Ensures that network providers are properly trained, licensed, and with appropriate capacity to provide services.

Participates in crisis calls as they relate to the provision of services.

Requests documentation to ensure psychological and/or psychiatric services are provided as needed.

Reviews documentation provided for youth's Service Planning as needed to ensure that Network Providers are providing quality, evidence-based services in compliance with the OCOK Provider Manual and other governing agencies.

Reviews and approves child assessment tools as needed.

Ensures quantified and measurable data is used during the child assessment phase to make appropriate decisions regarding the type and level of placement for the child and provision of services.

Ensures providers with higher level settings have the program and treatment models necessary to meet the complex needs of youth so that youth can heal from their trauma and step down to a less restrictive setting in accordance with treatment goals and length of stay compliance.

Promotes safety and encourages the least-restrictive and shortest length of out-of-home placement for children.

Communicates OCOK concerns with Network Providers while promoting a collaborative approach to improving services and increasing capacity.

Ensures contract outcome measures are met with an emphasis on improving the quality and capacity of the OCOK Provider Network, to include reducing disruptions and improving outcomes so that youth are prepared for permanency and adulthood.

Refrains from assuming any duty that is unrelated to and/or interferes with the responsibilities of the position.

Advocates, promotes, and practices cultural sensitivity and responsiveness in all day-to-day interactions.

Develops, promotes, and practices teamwork in all activities.

Completes other duties as assigned.

Training

Attends relevant in-service training offered at ACH to expand knowledge of services and the application of clinical skills.

Attends mandatory training such as, but not limited to, Emergency Behavior Intervention, CPR and First Aid, Psychotropic Medications and Trauma-Informed Care training.

Communicates regularly with Provider Relations manager and seeks supervision when appropriate.

Attends continuing education necessary to expand knowledge and maintain certifications or licenses.

Notifies supervisor properly when absent.

Ensures that all deadlines are met and decisions affecting OCOK are communicated.

Establishes effective working relationships with co-workers.

Deals satisfactorily with and acknowledges work-related stress.

Maintains appropriate boundaries between professional and personal issues.

Adheres to all policies and procedures of the agency and its accrediting and standard setting bodies, such as Council on Accreditation (COA) and state licensing.

Respects the dignity and worth of all clients and families.

Maintains client confidentiality per agency standards and all applicable codes of ethics.

Uses outside professional collaboration and intra-agency teamwork appropriate to the agency.

Learns, understands, and supports the agency's mission, purpose, and function.

Is prepared to address appropriate issues during supervisory conferences and meetings.

Accepts direction from supervisor and implements supervisor's suggestions and instructions.

Understands the job description in relation to other agency positions.

Continues to work to improve skills needed for position held.

Considers the environmental, cultural, safety, diversity issues and needs of the clients.

Identifies and understands the strengths, abilities, and competencies of the clients.

Continuously learns and becomes proficient in the application of all external oversight bodies that impact Network Providers. Uses that knowledge to help Providers successfully navigate those systems and continuously improve.

Requirements

Educational Requirements

A bachelor's degree from an accredited college or university is required; a master's degree in social work or related field is preferred.

Experience Requirements

A minimum of three years of experience working with children, youth, and families in foster care with experience and knowledge of the regulations that guide residential services. Experience with evidenced based treatment programming. Experience with quality assurance and risk management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of child's assessments and progress.

Functional Requirements

Must have excellent verbal and written communication skills and the ability to work collaboratively with youth, families, agencies, community professionals, and OCOK staff. Must be willing to increase knowledge in the application of all related standards that govern residential services. Must demonstrate excellent organizational skills as well as the ability to develop systems that support compliance. Must work autonomously to ensure that all deadlines are met, and tasks are completed. Must demonstrate an ability to continue learning through supervision, continuing education, and experience, and work cooperatively using a team approach. Must be willing to put into practice Trauma-Informed Care principles.