Under general direction of the Director of Behavioral Health, plans, organizes, manages, evaluates and supervises the activities that ensure the quality of client care and over-all quality/effectiveness of major programs within the County Behavioral Health Department; assigns and evaluates the work of multidisciplinary professional and paraprofessional staff and other support personnel, may plan and provide a variety of direct client behavioral health services, performs a variety of administrative work functions associated with ensuring fiscally sound utilization of behavioral health services; serves a primary role in the completion of the departments Performance Improvement Projects; serves as the departments Compliance Officer; serves as a liaison for the department with contracted direct service providers, community, regional, or State agencies DISTINGUISHING CHARACTERISTICS
This is middle level management position with primary responsibility for the administration of the quality improvement and compliance plans of a major department with multiple programs that include mental health and substance abuse branches. Incumbents are responsible for maintaining the quality of both staff and program performance and workload standards. This classification requires strong management and communication skills as well as problem solving skills and the ability to participate effectively in decision-making processes. This classification also requires a high degree of professional knowledge in the areas of mental health and substance abuse treatment/support services, federal and state laws and regulations related to MediCal and Medicare reimbursement and program operations. REPORTS TO
Director of Behavioral Health CLASSIFICATIONS SUPERVISED
This classification has no direct supervisor responsibility of specifically assigned staff, however the responsibilities of the position requires oversight, and evaluation of the work produced by multidisciplinary professional and paraprofessional staff and other support personnel. PHYSICAL REQUIREMENTS
Sit for extended periods; frequently stand and walk; normal manual dexterity and eye-hand coordination; lift and move objects weighing up to 25 lbs.; corrected hearing and vision to normal range; verbal communication; use of office equipment, including computer, telephone, calculator, copiers, and FAX. TYPICAL WORKING CONDITIONS
Work is performed in an office, clinic, homes, school, or community environments; work is performed with people who may exhibit unstable and potentially violent behavior; continuous contact with other staff and the public.
Examples of Duties / Knowledge & Skills EXAMPLES OF IMPORTANT AND ESSENTIAL DUTIES
(The following is used as a partial description and is not restrictive as to duties required.)
- Reviews client admission data and clinical documentation to ensure compliance with County and State regulations and policies relating to medical necessity and case documentation: when appropriate interviews clients, significant others, and consults with outpatient professional staff, and contract provider staff regarding client diagnoses, medical necessity, length of treatment and case documentation.
- Reviews case records and assesses for appropriate levels of care, aftercare and discharge planning.
- Represents the County in disputes with contract providers over appropriateness of treatment plans and length of stay in care.
- Advocates on behalf of the County with contract provider staff for appropriate client care.
- Provides training for professional, paraprofessional and contract provider staff on information about utilization and documentation requirements.
- Facilitates and participates with department staff in utilization review and quality improvement meetings.
- Evaluates financial status of inpatients at contactor inpatient facilities to identify payer sources;
- Posts and reconciles all payments from all payer sources for inpatient physician services and bed day charges;
- Records MediCal and Medicare payments, cutbacks and denials.
- Prepares comprehensive reports related to program operations and activities
- Works in a primary staff role in fulfilling the responsibilities for the design, implementation and completion of the departments Performance Improvement Projects
- Fulfills the responsibilities of the Compliance Officer as identified in the departments Compliance Plan
- Ensures the adherence to and fulfillment of the responsibilities of the department as described in the department's Annual Quality Improvement Plan
- Responds to requests for information and assistance
- Assists in the preparation for and participates in various state and federal program audits to ensure department compliance with MediCal and Medicare regulations
- Monitors and evaluates overall activities of assigned programs/functions, including contracted service providers/programs, methods and procedures for effectiveness and consistency with program goals and objectives, recommending and implementing upon Director approval changes in program, policies, and procedures as necessary.
- Files MediCal updates
- Operates a computer and updates files, records
The contents of this class specification shall not be construed to constitute any expressed or implied warranty or guarantee, nor shall it constitute a contract of employment. The County of San Benito assumes no responsibility beyond the general accuracy of the document, nor does it assume responsibility for any errors or omissions in the information contained herein. The contents of this specification may be modified or revoked without notice. Terms and conditions of employment are determined through a "meet and confer" process and are subject to the Memorandum of Understanding currently in effect .
Minimum qualifications & Requirements
Any combination of training and experience which would likely provide the required knowledge and abilities is qualifying. A typical way to obtain the required knowledge and abilities would be:
At least three years of licensed professional experience in a multidisciplinary Behavioral Health program which includes experience in administrative management and /or clinical supervision that demonstrates possession of the knowledge and abilities.
Completion of academic coursework and training as defined in Title IX for the California Administrative Code in one of the following:
- Ph.D. in clinical psychology from an accredited school;
- Master's degree in Social Work from an accredited school of social work;
- Master's degree in Marriage, Family and Child Counseling, Psychology, or Counseling from an accredited school.
- Registered Nurse, meaning a person licensed as a registered by the California Board of Registered Nursing.
Supplemental information Knowledge of:
- Quality review/quality assessment principles, practices, methods and techniques
- Pertinent laws and regulations regarding health and social service programs, including guidelines pertaining to reimbursement of health care services
- Federal, state and county regulations and policies pertaining to utilization review
- Laws and regulations pertaining to client's legal rights
- Basic pharmacology and the utilization of prescription drugs for treatment:
- Methods and procedures of admissions, discharges, and client care in outpatient and acute care psychiatric settings
- Principles, practices, and techniques of psychotherapy and psychiatric casework and substance abuse treatment
- Social aspects, attitudes, characteristics and behaviors of mental illness, emotional disturbances and addiction to drugs and alcohol
- Current developments in the field of Mental Health and Substance Abuse Treatment
- Community resources available to mental health and substance abuse programs
- Cultural, socio-economic and language factors that affect service delivery to ethnic populations
- Basic training and employee development principles and practices
- Basic mathematics and basic computer applications and techniques.
- Review and interpret healthcare documentation, including interpretation of clinical data and medical terminology pertaining to diagnosis, treatment and medication
- Ascertain facts through examination of records
- Collect, interpret and evaluate data
- Interpret complex regulations, laws and guidelines, formulate policies and procedures, rationalize and project consequences of decisions, and /or recommendations
- Establish and maintain effective relations with clients, the general public, contract providers and personnel at all organizational levels
- Prepare concise, logical oral and written reports and explain policies, procedures and recommendations
- Communicate effectively both orally and in writing
- Prepare and maintain accurate records
- Operate standard office equipment, utilize various software programs relevant to the responsibilities of the position
- Operate a motor vehicle;
- Assist in the establishment of program goals and objectives and evaluate their attainment, train, evaluate and motivate professional and support staff.
NOTE: The selection process will likely consist of a Training and Experience Evaluation (T&E) to produce a score in order to be placed on the eligible list. In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questions within the application are completed with care and diligence. Responses such as "See Resume" or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation.
In accordance with California Government Code section 3100, et., seq., all County of San Benito employees are considered disaster service workers who may be required to report for duty, or remain on duty to address disaster service activities in the event of an emergency or disaster and are required to undertake an applicable loyalty oath.
Closing Date/Time: Continuous