Personal Care Management Program Operations Manager

Personal Care Management Program Operations Manager is responsible for overseeing that all PCM administrative, referral, intake and orientation, consumer support, and functional skills training, and Issue Focused contractual requirements are met.  This role supports and empowers PCM Supervisors with knowledge to lead their teams to success with high quality.   The PCM Contractor responsibilities are outlined in Section 2.1, except for Section D. Evaluations, Re-evaluations. This position is part of the Community Services Leadership and the Health and Safety Committee. 

Essential Functions

Oversee and manage training and retraining regarding the PCA Program and how to conduct skills training including how best to identify issues and how best to resolve issues.

Oversee and support the PCM Administrative processes with the required recordkeeping, including Consumer records, Prior Authorization records, FST records, I+O Session records, Evaluations, Reevaluation, Service agreement, Consumer Assessment to Manage, Surrogate/AP Assessment to Manage, etc.

Oversee the quality management principles using a systematic approach to improving processes and outcomes through the application of continuous quality improvement principles. 

Ensure the annual satisfaction survey is sent out and results reported on the PCM quarterly report.

Support the PCM Referral and Consumer Support Supervisor with the oversight of the Communication Systems.  Work together with the PCM Issue Focused Supervisor to handle incoming phone calls.

Oversee and empower PCM Supervisors so that the PCM Contractual and timeline requirements are clear regarding referral, intake, and comprehensive skills training.

Oversee and clearly present how best to document skills training, administrative requests, and manage skills training requests.

Provide guidance and empower PCM supervisors to review individual consumer issues and provide direction to the appropriate best next steps according to contractual knowledge.  Assist in training to keep issues simple and clear, and act in accordance with the MH Regulations and PCM contract and appropriate amendments. 

Oversee the Issue Focused Skills Training services, and monitor outcomes of the FST being requested by the FI, MH or as determined by our PCM Skills Training staff and supervisors, using batch Skills Training in Zuke.

Assist in completing the EOHHS required PCM quarterly report, and responses to other reports/requests provided by EOHHS.

Use Zuke reporting to monitor quality and performance and identify areas for improvement.

Assist PCM Supervisors to oversee and monitor the workload of all referral, intake, quarterly, annual and consumer support/issues skills training staff, and monitor the ratio of consumer to staff.

Oversee and empower PCM program staff leadership to resolve inquiries from MassHealth, SCO, One Care, PACE or CCM, and process responses in accordance with rules, contracts and PCM regulations.

Provide support to PCM supervisors to offer direct staff coaching when oversight is necessary due to staff performance.  Monitor and support staff performance issues in the most timely manner.

Participate in monthly PCM meetings relating to administration and skills training and communication with  other departments, as needed.

Assist with the review and update of all PCM documented standard operating procedures, to ensure efficiencies and adherence to regulations.  Provide updates to Director of Community Services for final approval.

Oversee the update of Skills Training Handbook, and also the PCM Consumer handbook.  Work with PCM trainer and other staff to create and continually update a centralized training site.

Oversee the PCM termination process, along with PCM Clinical manager.

Refer all records requests to the TU Keeper of Records, and include Director of Community Services.

Contribute and provide required reporting to EOHHS.

Oversee best practices to conform with HIPAA Privacy and Security Rules.

Oversee that forms that are used by community staff are well stocked and that all required documents are mailed out as contract states.

This role is a Mandated Reporter. 

Must report all suspected fraud to your Supervisor or Program Director

Perform other duties as assigned by Supervisor or Program Director

Required Certificates, Licenses, Registrations, skills, abilities

A Degree in Human services or related field.

At least three year’s direct experience and knowledge of MASSHEALTH PCA Program.

Attention to detail required, in a supervisory role.

Basic computer skills in Microsoft Office/Outlook/Excel and the ability to navigate database.

Medical knowledge helpful.

Professional telephone manner, computer database skills, familiarity with office procedures and equipment. 

Excellent, interpersonal, communication, organization and writing skills.

This position requires the utmost cooperation in providing a positive environment to create a productive workplace

Physical Demands

 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. While performing the duties of this job, the employee is regularly required to talk and/or hear. The employee is frequently   required to sit; stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

Travel

Travel is required for this position. Must have a valid driver’s license and reliable vehicle to travel within assigned service area.

Other Duties

 Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of   the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.