JOB TYPE :
OPEN COMPETITIVE JOB OPPORTUNITY
FILING START : MARCH 24, 2021 AT 8:00 A.M.This examination will remain open until the needs of the service are met. Application filing may be suspend at any time with or without advance notice.
This position will provide management leadership to the Central Business Office, which will assume responsibility for Medi-Cal and Medicare revenue reimbursement and reconciliation activities for the Department, as well as providing oversight of mental health service claim management, including verification for contract provider payments; mental health service claiming education and training, and policy and procedure development consistent with contractual, legal and programmatic requirements.
Essential Job Functions
Direct through subordinate managers the development and implementation of processes and procedures to ensure the Department's claims for the provision of mental health services (estimated at more than $1.5 billion annually) meet Federal, State, commercial insurance and/or other third-party payer source requirements.
Direct the analysis and interpretation of federal and state regulations pertaining to claiming for mental health services to determine impact on the Department's core business and prepare comments and/or recommend official County position on those proposed changes; communicate County position on proposed policy and/or procedures changes to advocacy organizations.
Direct the development of policies, procedures, manuals, training programs, and other support systems for both directly operated and contracted service providers to ensure the timely provision of instruction on compliance with all federal, state and local laws, rules and regulations pertaining to client financial screening, claiming to all payer sources and client billing.
Represent the Department with multiple external entities including State and federal officials, internal divisions, other county department, public and private agencies, and community and provider groups concerning funding and claims management issues.
Direct through subordinate managers the preparation of Medi-Cal revenue forecasts for budgetary purposes.
Direct through subordinate management, directly operated and contract provider claiming to Medi-Cal as well as directly operated claiming to Medicare and other health care payers insuring compliance with federal, state and local laws related to client financial operations and claiming and follow up activities related to error correction and claims denial management.
Through subordinate supervisors, authorize DMH Accounting to complete the Certified Public Expenditure (issue payment) to legal entity and fee for service providers for mental health services provided in compliance with contractual, legal and programmatic requirements.
Direct subordinate staff liaison activities with the DMH Chief Information Office Bureau on matters pertaining to the operation of the claim management data system to ensure the uninterrupted flow of claim data from directly operated and contract clinics to the State for reimbursement.
Monitor the status of claims submitted for reimbursement for the provision of mental health services; direct the activities necessary to file appeals or corrections of claims denied for payment or disallowed as the result of audit, and reconcile approved reimbursements with approved reimbursement rates and actual payments.
Oversee the implementation of new program claiming and reimbursement rules.
Serve as consultant to executive management on existing and proposed Central Business Office related operations. Advise management of the financial implication of those operations.
Requirements MINIMUM REQUIREMENTS:
Four years' responsible experience in an administrative* or staff capacity**, two years of which must have been within the field of health financial management at the level of Revenue Manager l***, Fiscal Officer ll****, or higher.LICENSE:
A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.PHYSICAL CLASS:
2 - Light: Light physical effort which may include occasional light lifting to a 10 pound limit, and some bending, stooping or squatting. Considerable walking may be involved.SPECIAL REQUIREMENT INFORMATION:
NO OUT-OF-CLASS EXPERIENCE WILL BE ACCEPTED.
*Administrative is defined as work performed in an administrative services branch of an organizational unit, including responsibility for the development of procedures and participation in policy formulation.
**Staff capacity is defined as work performed to assist and support administration by conducting research and making recommendations to administration for the solution of problems such as organization, use of personnel, budget allocation and funds, workload and/or workload fluctuations, or programs and procedures for accomplishing work objectives.
***In the County of Los Angeles, Revenue Manager I is defined as, manages and evaluates the revenue generating and cost recovery activities for a 300-500 bed teaching hospital with outpatient clinics capable of 15,000-20,000 clinic visits per month and for the region of which the hospital is a part.
****In the County of Los Angeles, Fiscal Officer II is defined as, directs the work of a large staff (more than 55) in the operation of a large to very large scale complex accounting program through a subordinate accounting officer or accountant functioning at a responsible level and in the work of a large group of related activities; and in addition, has major substantive non-accounting financial or budgetary responsibility in a department or institution having an annual budget of over $50,000,000.
*****In order to receive credit for any college or university course, or any type of college or university degree, such as Bachelor's or higher, you must include a legible copy of the official diploma or official transcripts from the accredited institution which shows the area of specialization with your application at the time of filing or within 15 calendar days of filing to firstname.lastname@example.org
. Official Transcript is defined as a transcript that bears the college seal and states "official and/or copy" issued by the school's Registrar Office. A printout of the transcripts from the school's website is NOT considered official and; therefore, will NOT be accepted and may result in your application being incomplete or rejected. DESIRABLE QUALIFICATIONS:
• Demonstrated experience in federal, state and county government health care, mental health or public health funding structures and functions, as well as their programs and services.
• Demonstrated experience in healthcare insurance billing.
• Demonstrated experience working in healthcare or mental health claiming policy, or fiscal policy analysis.
• Experience interacting with local, state, and federal government officials.
• Experience working with Electronic Health Record (eHR).
• A Bachelor's degree***** or higher in Business Administration, or Public Admin istration from an accredited college or university.
Additional Information EXAMINATION CONTENT:
This examination will consist of an evaluation of training, experience based upon application information and desirable qualifications weighted 100%. The evaluation of training, experience, and desirable qualifications will be based on application information and the information submitted on the supplemental application form at the time of filing.CANDIDATES MUST ACHIEVE A PASSING SCORE OF 70% OR HIGHER IN ORDER TO BE PLACED ON THE ELIGIBLE REGISTER. ELIGIBILITY INFORMATION
Applications will be processed on an "as-received"
basis and those receiving a passing score will be promulgated to the eligible register accordingly. The names of candidates receiving a passing grade in the examination will be placed on the eligible register in the order of their score group for a period of twelve (12) months following the date of promulgation.SPECIAL INFORMATION:
Past and present mental health clients and family members are encouraged to apply.VACANCY INFORMATION:
The resulting eligible register for this examination will be used to fill a vacancy within the Department of Mental Health, Central Business Office.
Appointees may be required to work any shift, including evenings, nights, weekends and holidays.APPLICATION AND FILING INFORMATION:
Applicants are required to complete and submit an online Los Angeles County Employment Application AND Supplemental Questionnaire in order to be considered for this examination. Paper applications, resumes, or any unsolicited documents will not be accepted in lieu of completing the online application and Supplemental Questionnaire. We must receive your application by 5:00 pm, PT, on the last day of filing.INSTRUCTIONS FOR FILING ONLINE
Applicants must complete and submit their online applications and upload required documents (e.g. Official Transcripts, Resume, etc.) as attachment(s) during application submission, or send by email to email@example.com within 15 calendar days from date of application submission. Indicate the Exam Title on the subject line when sending required documents by email.
For the time being, all notifications, including results letters and notices of non-acceptance, will be sent electronically to the email address provided on the application. It is important that you provide a valid email address. Please add firstname.lastname@example.org and email@example.com to your email address and list of approved senders to prevent email notifications from being filtered as spam/junk/clutter mail.
Applicants have the ability to opt out of emails from LA County. If you unsubscribe, you will not receive any email notification for any examination for which you apply with Los Angeles County. Regardless of whether you choose to unsubscribe, you can always check for notifications by logging into governmentjobs.com and viewing your profile inbox, which saves a copy of all emailed notices.
The acceptance of your application will depend on whether you have clearly shown that you meet the Selection Requirements. Your online application must show complete license, education and work experience information necessary to evaluate your qualifications. Education information section must include name and address of school attended, complete dates attended, name of course/s taken, number of units earned, and degree/s earned. Work experience section must include job title, employer name and address, name of work area/facility, actual payroll title held and not the working and/or functional titles, from/to dates of employment including month, day and year, total number of months, total number of hours worked per week - not a range of hours (full or part-time), and complete detailed description of related job duties. If range of hours is provided, experience will be prorated based on the lowest number of hours worked per week. List separately each job experience to be evaluated.IMPORTANT NOTES:
- All information is subject to verification. Applications may be rejected at any stage of the selection process.
- Utilizing VERBIAGE from class specifications and Selection Requirement serving as your description of duties WILL NOT be sufficient to demonstrate that you meet requirements. Doing so may result in an INCOMPLETE APPLICATION and you may be DISQUALIFIED.
The County of Los Angeles is a Fair Chance employer. Except for a very limited number of positions, you will not be asked to provide information about a conviction history unless you receive a contingent offer of employment . The County will make an individualized assessment of whether your conviction history has a direct or adverse relationship with the specific duties of the job, and consider potential mitigating factors, including, but not limited to, evidence and extent of rehabilitation, recency of the offense(s), and age at the time of the offense(s). If asked to provide information about a conviction history, any convictions or court records which are exempted by a valid court order do not have to be disclosed.
SOCIAL SECURITY NUMBER Please include your Social Security Number for record control purposes. Federal law requires that all employed persons have a Social Security Number.
NO SHARING USER ID AND PASSWORD All applicants must file their applications online using their own user ID and password. Using a family member or friend's user ID and password may erase a candidate's original application record.
COMPUTER & INTERNET ACCESS: Though LA County Libraries remain closed due to the pandemic, select locations are loaning out laptops and mobile wifi hotspots. DEPARTMENT CONTACT:
HR Examinations Unit: (213) 972-7034
HR Examinations Unit Email: firstname.lastname@example.org
Analyst Contact Email: Celia Yeung, email@example.comADA COORDINATOR PHONE:
(323) 705-4249TELETYPE PHONE
: (800) 735-2922CALIFORNIA RELAY SERVICES PHONES
: (800) 735-2922