The Network Improvement & Accountability Collaborative (NIAC) Clinical Consultant is responsible for conducting site visits of all funded providers in the Department of Behavioral Health & Intellectual disAbilities Services (DBHIDS) to ensure quality care is delivered, sound clinical practices are followed and regulatory requirements are met.

• Conducts analysis of programs at provider locations to determine alignment of program practices and outcomes with the DBHIDS Practice Guidelines.

• Reviews and analyzes agency service contract information through such means as clinical documentation, focus groups, individual interviews with agency staff and persons receiving services, and policies and procedures to determine accessibility to care; individualized practices; an atmosphere that promotes strength, recovery, & resilience; integrated services & supports; quality care management; supportive program operations; and ongoing evaluation & quality improvement

• Evaluates the medical treatment being delivered in relation to diagnoses, prognosis, and recovery/resilience plans.

• Ensures that best practice therapeutic modalities are being implemented and determines effectiveness of treatment.

• Analyzes medications dispensed in relation to diagnosis to ensure appropriateness and prevent the possibility of contraindications.

• Establishes with therapeutic staff and client if clinical progress has been achieved and ascertains appropriateness of level of care transition, based upon effectiveness of treatment plan.

• Meets with medical staff to review and discuss Metabolic Syndrome screening to ensure that screening criteria are correct and complete.

• Identifies areas of concern that require higher level of medical review in consultation with DBHIDS physicians and/or psychologists.

• Collaborates with colleagues participating in the site visit to assign objective scores to analyzed criteria in order to provide an overview summary of provider practices.

• Participates in entrance and exit conferences with provider at end of site visit to summarize findings and review recommendations.

• Based upon findings, prepares written report in a timely and cohesive manner, or contributes information for inclusion in written report, to document findings and recommendations, citing appropriate clinical documentation to support strengths or areas needing improvement.

• Reviews Quality Improvement Plans submitted by providers, as assigned, and conducts follow up as needed.

• Conducts regulatory analysis to ensure compliance with federal, state and local requirements, including but not limited to Bureau of Drug & Alcohol Programs (BDAP), Office of Mental Health (OMH),

• Behavioral Health Special Initiative (BHSI) and/or Community Behavioral Health (CBH) requirements, as well as newly created NIAC activities.

• Serves as site visit facilitator on a rotating staff basis. This responsibility includes, but is not limited to, acting as the point of contact for a site visit; organizing the assigned NIAC reviews identified; coordinating the preparation meetings, entrance and exit conferences; identifying and analyzing billing records in order to select charts for review; and ensuring reports are cohesive and detailing all meaningful information.

• Educates agency staff around issues of DBHIDS policies and procedures and state regulations.

• Forwards quality concerns to the Quality Review Department and the Consumer Satisfaction Team (CST) for referrals and resolution.

• Collaborates with internal staff across DBHIDS (e.g., Contracts and Budgets to get up to date budget information prior to a Site Visit; Clinical Management regarding any clinical concerns, etc) to identify unique concerns related to specific programs and ensure appropriate internal communication.

• Correlates and analyzes data acquired through the site visit process.

• Identifies potentially fraudulent provider activity through agency file reviews and focus groups with staff and individuals receiving services.

• Attends regularly scheduled meetings.

• Travel to provider locations, which will at times be outside of Philadelphia County.

• Knowledge of the Philadelphia Behavioral Health Services Transformation Practice Guidelines for Recovery and Resilience Oriented Treatment

• Knowledge of behavioral health therapeutic modalities, with emphasis on current best practices within the field.

• Knowledge of medical necessity criteria for the American Society of Addiction Medicine (ASAM) Placement Criteria.

• Knowledge of psychotropic and physical health medications, interactions, contraindications, side effects, and appropriateness of use in relation to diagnosis.

• Knowledge of Diagnostic and Statistical Manual of Mental Disorders (DSM).

• Knowledge about medical assistance regulations as well as knowledge of the laws, regulations, and guidelines in the behavioral health disciplines.

• Knowledgeable about services the provider is contracted/budgeted to provide.

• Knowledge of the principles and practices of administration as they apply to the promotion and coordination of programs and services within behavioral health.

• Understanding of diagnostic criteria and appropriate treatment approaches, clinical guidelines and best practices in the behavioral health field.

• Excellent analytical skills.

• Proficiency in the use of Microsoft Excel, Word and PowerPoint.

• Excellent writing skills and ability to summarize reports in a concise and comprehensive manner.

• Excellent communication skills to include presentation to large groups in a public forum.

• Ability to maintain professional relationships with both internal and external staff.

• A demonstrated ability to work cooperatively and communicate effectively, both within the Behavioral Health System and with a wide variety of individuals and agencies representing varying treatment perspectives.

• Ability to interpret local, state, and federal laws, regulations, and ordinances.

• Completion of a master’s degree program at an accredited college or university in a behavioral health or closely related discipline.

• Four (4) years’ experience in assessment and/or counseling within an adult or child/adolescent behavioral health treatment setting.

• Possession of a valid proper class motor vehicle operator's license as issued by the Commonwealth of Pennsylvania, and an acceptable Motor Vehicle Report (MVR) prior to appointment and during tenure of employment.

• Pennsylvania Child Abuse History Clearance and F.B.I. Clearance

• Ability to travel independently, ride public transportation as necessary and do at least 2 flights of stairs