Utilization Review Manager (Behavioral Health Supervisor)

About the role

This position plays a critical role in serving children and families in our community who require intensive behavioral health interventions and support. As the Children’s Services Act (CSA) Utilization Review Manager, you will supervise a team of senior clinicians to review requests for services and authorize funding for a continuum of services and supports. Working closely with staff from child-serving agencies such as child welfare, juvenile justice, special education, and community mental health, the Utilization Review (UR) team ensures that high-quality, effective, trauma-informed, and evidence-based interventions are offered.

This role involves collaborating with quality assurance, procurement, fiscal teams, and data analytics to balance service delivery with effective, outcome-focused interventions. You will support the implementation of the System of Care model in Fairfax-Falls Church, working in a dynamic human services environment to manage and interpret complex policy and unique child-specific needs.

Responsibilities

• Supervises and manages a team of behavioral health senior clinicians to review and authorize requests for intensive behavioral health services and supports.
• Provides oversight to ensure service authorizations comply with state and local policy, meeting programmatic and fiscal audit standards.
• Participates in management and leadership teams as well as interagency workgroups to support strategic initiatives aimed at improving equitable access, effective service delivery, and improved outcomes for youth involved in child welfare, juvenile justice, and special education.
• Leads collaborative efforts and engages with private provider partners to ensure a full continuum of high-quality, trauma-informed, and evidence-based interventions are available.
• Supports implementation of the System of Care model in Fairfax-Falls Church to accomplish strategic priorities for youth with complex, intensive needs.
• Utilizes technology solutions, electronic documentation systems, and virtual platforms for efficient business processes in a dynamic human services environment.
• Collects and analyzes qualitative and quantitative data to provide management reports to leadership about service trends, gap analyses, and other program metrics.
• Provides staff supervision for all clinical aspects of the program; plans, assigns, and reviews work of team members.
• Consults with professionals on a variety of problems, including delivery of needed services for clinically complex cases.
• Serves as a liaison to community agencies to facilitate communication and service provision for individuals requiring multiple services.
• Develops and implements program activities and services, including training and educational activities.
• Supervises day-to-day program operations and promotes awareness of program services through presentations.
• Develops and monitors program policies and procedures to ensure compliance with applicable federal, state, and local regulations.
• Mediates and facilitates inter- and intra-program issues needing a systems perspective.
• Plans, recommends, and executes quality initiatives related to mental health standards.

Requirements

• Extensive knowledge of the principles, theories, and methods of the psychological and social development of humans.
• Thorough knowledge of and ability to implement recovery-oriented practices and person-centered planning.
• Knowledge of psychiatric, psychological, sociological, and addiction terminology and concepts.
• Knowledge of clinical supervisory methods and techniques.
• Knowledge of existing referral agencies and community resources.
• Demonstrated case management skills.
• Ability to evaluate the severity of individuals' substance use, psychiatric symptoms, and impact on daily functioning; and implement commensurate levels of treatment and support.
• Ability to prepare, produce, and conduct program presentations.
• Ability to develop, implement, manage, and evaluate programs.
• Ability to supervise and train service professionals.
• Ability to successfully perform as a team leader/member.
• Ability to evaluate performance, provide feedback, coach, correct, and implement personnel procedures.
• Ability to function independently in high-stress situations.
• Ability to develop and maintain effective working relationships with subordinates, co-workers, supervisors, public and private sector organizations, community groups, and the general public.
• Ability to communicate effectively, both orally and in writing.
• Ability to maintain records and prepare reports.

Qualifications

• Graduation from an accredited college with at least a master’s degree in social work, psychology, counseling, or nursing plus three years of clinical experience, or a doctoral degree in psychology, social work, counseling, or nursing plus one year of clinical experience.
• Must be eligible to be licensed to practice in the Commonwealth of Virginia in one of the following: Licensed Clinical Social Worker, Licensed Professional Counselor, Clinical Psychologist, Licensed Marriage and Family Therapist, Licensed Substance Abuse Treatment Practitioner, or Licensed Nurse Practitioner (LNP).
• Licensed to practice in the Commonwealth of Virginia in one of the above disciplines (required within 24 months).
• Valid driver’s license.

The appointee to this position will be required to complete a criminal background check, child protective services check, and driving record check to the satisfaction of the employer.

Preferred Qualifications

• At least 3 years of experience supervising professional staff.
• At least 2 years of professional human services work experience in at least two areas.
• At least 2 years of professional experience monitoring behavioral health care services.
• Advanced knowledge of trauma-informed, evidence-based mental health/behavioral health care interventions for children, youth, and families.
• At least 2 years of experience in at least two of the following areas: utilization review, monitoring of purchased mental health/behavioral health care services, collection of standardized data elements via file audits and document reviews, preparing written social histories, assessments, and reports describing the needs of children and families, and use of assessment tools (e.g., CANS, VEMAT, YASI, etc.) and decision support models.
• At least intermediate proficiency with Excel.

Physical Requirements

• Ability to communicate clearly and concisely, both orally and in writing.
• Ability to travel to visit clients, conduct site reviews, and attend meetings off-site.
• Ability to use automated technology.
• May be required to lift up to 15 lbs.
• Visual acuity is required to read data on a computer monitor; must be able to operate keyboard-driven equipment.

All duties performed with or without reasonable accommodations.