6 days old

Project Manager

Keystone Peer Review Organization, Inc.
Jackson, MS 39202
  • Job Code
    PROJE02531-00001



Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.Kepro is seeking resumes for a highly experienced professional.



Project Manager



Summary Description



Directs and oversees all program activities to ensure overall consistency, thoroughness, and accuracy of the Preadmission Screening and Resident Review (PASRR) Level I reviews and Level II evaluations in collaboration with the Mississippi Department of Mental Health (DMH) and Division of Medicaid (DOM). Directs program to ensure efficiencies, deliverables and assigned contract functions are performed to the highest standards to strengthen the relationships with customers and meet contract requirements. Provides day-to-day oversight to manage the PASRR program and is responsible for overseeing the implementation of the Contract requirements.



Accountabilities



  • Directs program to ensure accurate PASRR evaluations through accurate clinical assessment of the patient, relevant records and collateral sources of individuals with suspected or confirmed mental illness to determine the presence of a Serious Mental Illness (SMI), as defined by 42 CFR 483.102(b)(1), Intellectual Disability or Other Related Conditions (ID/RC) as defined by 42 CFR 483.102(b)(3).

  • Direct liaison to the state must be available to DOM during regular business hours of DOM operation.

  • Directs program to ensure accurate PASRR review completion by determining appropriate level of care based on the patients physical, behavioral, and psychological functioning.

  • Effectively directs program through objectives and goals assigned for contract compliance. Monitors metrics and daily operations to ensure success.

  • Collaborates with program leaders, including medical director, management teams, and corporate support teams to improve processes, determine training needs and improvement opportunities. Assists in budget review and management.

  • Responds to state inquiries regarding any PASRR activities.

  • Oversees budget review and analysis to ensure the financial success of the program.

  • Understands and keeps up with current literature, regulations and research related to long term care, mental illness, medical conditions and geriatrics.

  • Provides training, technical assistance, and clinical support to customers. Statewide training of nursing facility and hospital providers, state staff, and internal staff/field evaluators.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.



Qualifications



  • Registered Nurse, licensed in the state of Mississippi, Licensed Clinical Social Worker, Licensed Clinical Psychologist, Nurse Practitioner or other qualified Licensed Mental Health Professional approved by state PASRR authority.

  • Graduation from an accredited College with relevant Degree Program.

Knowledge, Skills, Abilities



  • Knowledge of Federal Regulation 42 CFR, Chapter 483.

  • Knowledge of Medicaid programs with relevant experience navigating similar complex projects.

  • Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in Mississippi.

  • Knowledge of standards of practice related to determination of Level of Care.

  • Knowledge of standards of practice related to mental health, geriatric and other disorders typically requiring long term care placement.

  • Knowledge and understanding of public sector services and supports.

  • Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.

  • Ability to determine a clinical diagnosis accounting for psychological and behavioral issues.

  • Ability to utilize computer equipment and web based software to conduct work.

  • Ability to interact with various office staff as needed to support necessary workflows.

  • Ability to interact with healthcare professionals, patients, their families and other supports.

  • Ability to communicate effectively to individuals and groups through spoken, written and electronic media.

  • Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.

  • Assesses and analyzes psychological, emotional, behavioral and physical functioning.

  • Develops level of care recommendations based upon clinical evaluations.

Experience



  • Minimum experience of seven (7) years managing and/or working with Medicaid, government health plans, or PASRR programs is required.

Mental and Physical Requirements



The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.



KEPRO offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements.Only those candidates identified for an interview will be contacted.No Phone Calls Please.Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.



EOE AA M/F/Vet/Disability



KEPRO is and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.



Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities



The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c)



See job description





Posted: 2020-06-29 Expires: 2020-07-28
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Project Manager

Keystone Peer Review Organization, Inc.
Jackson, MS 39202

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