Quality Care Management Coordinator

Description
SALARY: $49.72 - $59.92 hourly $103,417.60 - 124,633.60 annually

The County of Santa Barbara Behavioral Wellness Department is accepting applications to fill two (2) full-time Quality Care Management (QCM) Coordinator vacancies. The selected candidate may need to travel between different operational sites within Santa Barbara County that includes Santa Barbara, Santa Maria, and Lompoc. Quality Care Management (QCM) Coordinator is the working title for this position and encompasses the concept that the incumbent will work performing the duties of a Quality Assurance Coordinator. The County job classification associated with this title is Quality Assurance Coordinator.

We are also establishing one employment list to fill future full-time, part-time, and extra-help (temporary) and *1414 vacancies.

*1414 vacancies may occur as a result of a leave of absence (Civil Service Rule 1414) and the duration of the appointment shall be subject to the return of the individual who is on leave. A person who is appointed to a position under Civil Service Rule 1414 may be able to transition into a regular position in the classification without re-application or re-testing, depending on the performance of the appointee and the needs of the department.

BENEFITS: For more information on County of Santa Barbara benefits click HERE or visit the Benefits Tab above. Additionally, applicants from other public sector employers may qualify for retirement reciprocity and time and service credit towards an advanced vacation accrual rate.

THE POSITION:

This position works within the Quality Care Management division of the Behavioral Wellness Department. The Quality Care Management Coordinator reports to the Quality Care Management Program Manager. Under general direction, the selected incumbent will conduct and coordinate quality improvement and utilization review activities of mental health and alcohol and other drug services for the Department of Behavioral Wellness and for contracted providers; and performs related duties as required.

Incumbents in this class work in a system of interdisciplinary departmental teams and/or contract service agencies providing assessment, prevention, intervention, treatment, and related ancillary support services via an integrated service delivery system to people with alcohol and other drug related problems, mental illness, and/or co-occurring conditions.

The work schedule for this position will depend upon the needs of the Department.

ABOUT THE DEPARTMENT:

The County of Santa Barbara's Department of Behavioral Wellness isresponsible for ensuring the provision of mental health services mandated by the State of California for children with serious emotional disturbance, adults with serious mental illness, and all Medi-Cal beneficiaries with specialty mental health needs. Behavioral Wellness also provides substance use disorder treatment services for Medi-Cal beneficiaries. Our Mission is to promote the prevention of and recovery from addiction and mental illness among individuals; families and communities by providing effective leadership and delivering state-of-the-art, culturally competent services that are guided by measurable client-specific outcomes. Behavioral Wellness annually provides treatment, rehabilitation and support services to approximately 9,800 clients (3,000 children/adolescents and 6,900 adults) with mental illness and 4,500 clients with substance use disorders. For more information, please visit: www.countyofsb.org/behavioral-wellness

The Ideal Candidate will:

• Knowledge of California Mental Health Plan and Drug Medi-Cal Organized Delivery Systems including recently enacted laws tied to the Managed Care Final Rule and Drug Medi-Cal Organized Delivery System.
• Demonstrated ability to develop and maintain sound working relationships with people of diverse backgrounds and personalities.
• Experience in clinical and/or managed care planning and oversight.
• Strong background as a licensed mental health professional.
• Experience managing and monitoring regulations.
• Experience in utilization review.
• Experience and/or education in alcohol and other drug services.
• Excellent oral and written communication skills and the ability to interact with all levels of internal and external customers.
• Detail oriented while handling multiple projects with competing priorities.
• Organized and prioritize work, and meet deadlines.
• Processes, interprets and communicates complex contractual information to internal and external clients.
• Open to change and new information, and adapt behavior and work methods in response to new information, changing conditions, and unexpected obstacles.
• Bilingual skills in English/Spanish is highly desirable, but not required.

Examples of Duties

1. Develops and implements policies and procedures for the utilization review function to assure the effective utilization of medical or psychiatric services, and appropriate service reimbursement; reviews requests for authorization of services to determine whether the diagnosis and proposed treatment fall within the criteria for service reimbursement and authorizes treatment or refers the request to a higher medical authority; and authorizes reimbursement of contracted inpatient and outpatient services.
2. Collects and reviews statistics of services provided using automated systems to determine effectiveness and quality of care provided and to assess whether changes in the program are necessary to provide optimum health or psychiatric care in the most cost-effective manner; and generates reports from automated system.
3. Works with beneficiaries, providers, co-workers, and other public agencies to discuss or explain services provided or denied, give direction or authorization for specialized treatments, and establish eligibility of beneficiaries for services.
4. Collaborates with fiscal intermediaries, medical staff or mental health professionals, and others to review and interpret patient records and documentation when requests/claims for reimbursements are denied; writes narrative and statistical reports on utilization reviews; and prepares correspondence using word processing software.
5. Reviews state regulations; reviews policies and procedures and makes recommendations to management on methods to conform to regulations; educates staff on regulation changes; meets regularly with care providers to identify and address utilization review issues; and conducts training sessions for clinical and support staff on utilization review and documentation.
6. Assigns, reviews, and evaluates the work of professional, technical, and clerical staff.

Employment Standards

Applicants must meet the employment standards (minimum qualifications) list below to be considered for this position. Detailed information should be included in the application.

1. Three (3) years of clinical experience as a licensed mental health professional as defined by California Code of Regulations, Title 9, Chapter 11, *1770 (including registered nurses, licensed clinical social workers, and marriage and family therapists). Work must have included some experience planning, organizing, and evaluating program operations and staff; OR,
2. Three (3) years of clinical experience as an ASW or MFT intern or other waivered/registered Point of Authorization staff as defined by California Code of Regulations, Title 9, Chapter 11, *1770 and 1820.200. Work must have included some experience planning, organizing, and evaluating program operations and staff; OR,
3. A combination of training, education, experience, and licensure or registration that is equivalent to one of the employment standards listed above and that provides the required knowledge and abilities.

Professional Licensure: Where licensure is required, applicants must possess licensure in their profession at the time of application. Initial appointment may be based upon comparable licensure in any state; however, California licensure is required within two years of appointment as a condition of continued employment.

Additional Requirements: This position requires travel within the County on a weekly basis. A valid driver's license is required at the time of application. A valid California Class C Driver's License is required at the time of appointment.

Knowledge of: State regulations applicable to treatment and reimbursement under Medi-Cal and other third party payers; basic utilization review procedures and techniques; medical and surgical, mental health, or alcohol and drug diagnoses, procedures, and types of treatment; basic principles and practices of supervision; and English grammar and usage.

Ability to: Prepare and maintain accurate records; interpret rules and regulations; read and understand patient records; work tactfully and effectively with staff, patients, families, fiscal intermediaries, and providers; prepare clear and concise reports using correct grammar, punctuation, and spelling; maintain objectivity and confidentiality; gather and analyze data, draw conclusions, and make recommendations; communicate effectively, both one on one and in groups; and use word processing, spreadsheet, and database applications on personal computer.
Supplemental Information

APPLICATION & SELECTION PROCESS:

1. Review applications and supplemental questionnaire to determine those applicants who meet the employment standards.

1. Supplemental Questionnaire Ranking: Candidates' response to the required supplemental questionnaire will be evaluated and scored. Candidates' final score and rank on the employment list will be determined by their responses to the supplemental questionnaire. This process may be eliminated if there are fewer than eleven (12) qualified candidates.

Applicants must receive a percentage score of at least 70 on the supplemental questionnaire to be placed on an employment list. An adjustment may be made to raw scores based on factors listed in Civil Service Rule VI. Those candidates who are successful in the selection process will have their names placed on the employment list for a minimum of three months. At the time the employment list is established, all candidates will receive written notice of their score on the exam(s), rank on the employment list, and exact duration of the employment list.

CONDITIONAL JOB OFFER:

• Live Scan and Background Check: Once a conditional offer of employment has been made, the selected candidate's appointment is contingent upon successful completion of a Live Scan and background check which includes a conviction history check, and satisfactory reference checks. A Live Scan is electronic fingerprint scanning that is certified by the State Department of Justice. Further instructions about when and how to complete the Live Scan will be included in the offer letter. Appointee will be subject to a post-offer medical evaluation or examination.
• The appointee must satisfactorily complete a one-year probationary period.
• Background Investigation: Finalists for positions in this class will be required to pass a pre-offer, job-related background investigation.

Recruiters will communicate with applicant by e-mail during each step in the recruitment process. Applicants are reminded to check spam filters continuously during the Recruitment & Selection Process steps listed above to ensure they do not miss required deadlines. The County of Santa Barbara will not release any applicant's email address to a third party.

REASONABLE ACCOMODATIONS: The County of Santa Barbara is committed to providing reasonable accommodation to applicants. Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter listed on the job posting. We require verification of needed accommodation from a professional source, such as a Medical Provider or a learning institution.

STATEMENT OF COMMITMENT
The County of Santa Barbara is dedicated to cultivating and sustaining an environment that exhibits equity and inclusion everywhere, and at all levels of our organization. The County believes equity is a fundamental principle that must be imbedded in policies, institutional practices and systems. The County recognizes the negative impacts of systemic racism and is committed to eliminating the barriers affecting our Black, Latinx, Indigenous, and Asian community members, as well as people of other diverse racial and ethnic backgrounds. We envision a world where society and its systems (e.g. education, criminal justice, and health care, housing the economy) are just, fair, and inclusive, enabling all people to participate and reach their full potential.

We celebrate community and employee diversity, strive for inclusion and belonging, and promote empowered participation. We aspire to build a workforce that is reflective of these values and the communities we serve. We are proud to be an equal opportunity employer and will resolutely uphold federal, California state law and/or Santa Barbara County ordinances.

We believe equity and inclusion are vital to fulfill the County's mission and to embody a culture of "One County, One Future." Expanding the full range of employee talent allows the County to deliver our best to all our community members.

We believe in the dignity and humanity of all people. We strive for a healthy and prosperous society that promotes all people having equitable access and opportunity.

Disaster Service Worker: Pursuant to Governmental code section 3100, all employees with the County of Santa Barbara are declared to be disaster service workers subject to such disaster service. Activities as may be assigned to them by their superiors or by law.

APPLICATION AND SUPPLEMENTAL QUESTIONNAIRE DEADLINE: Monday, December 2, 2024 by 4:59 PM PST. Applications and job bulletins can be obtained 24 hours a day at www.sbcountyjobs.com.

Amaris Tang, Assistant HR Manager, Department of Behavioral Wellness - BWELLRequestToFill@sbcbwell.org