Posted on: Oct.25.2022
BHRS Utilization Review- Quality Improvement Specialist, County of Marin, Hybrid remote, San Rafael, CA, USA
Salary: $7,290.40 - $8,789.73 Monthly
Location: San Rafael, CA
Job Type: Full Time, Regular
Remote Employment: Flexible/Hybrid
Department: Health & Human Services
Job Number: 1090-22-10
Closing: 11/8/2022 4:00 PM Pacific
Vacancies: 1
Weekly Schedule: 40 hrs.
Differential: 6% for Professional License
Equal Employment Opportunity
The County of Marin is an Equal Opportunity Employer. Persons of color, women and individuals with disabilities are strongly encouraged to apply.
Individuals with Disabilities
If you are a person with a disability and are unable to complete an online application or require an accommodation to participate in a recruitment, you must contact Human Resources at least five work days in advance of the testing step or interview. Please contact the Human Resources Staffing Division at (415) 473-2126 (CRS DIAL 711) .
ABOUT US
At the County of Marin, our employees overwhelmingly report feeling their work is meaningful, they like the work they do, and they are proud to tell people "I work for the County of Marin." Discover more about us
DEPARTMENT OF HEALTH & HUMAN SERVICES:
At Health & Human Services, we serve our community through the values of support, unity, trust and excellence with one common goal: to promote and protect the health, well-being, safety and self-sufficiency of all in Marin. Join our team of bright, committed and energetic people who also want to make an impact through public service.
ABOUT THE POSITION
The Marin Behavioral Health and Recovery Services’ Quality Management (QM) program is responsible for monitoring the effectiveness and for providing support to all areas of operations by conducting performance monitoring activities which include, but are not limited to: utilization management, utilization review of Mental Health Inpatient and Outpatient services and DMC-ODS Substance Use services, provider appeals, credentialing and monitoring, resolution of beneficiary grievances, and analysis of beneficiary and system outcomes. The QM program’s activities are guided by the relevant sections of Federal and California State regulations, including the Code of Federal Regulations Title 42, the California Code of Regulations Title 9, Welfare and Institutions Codes, CalAIM, as well as the MHP’s performance contract with the State Department of Health Care Services (DHCS). For more information: https://www.marinbhrs.org/about-us/qm
Under the direction of the Quality Improvement Coordinator, the BHRS Utilization Review/ Quality Improvement Specialist conducts utilization review activities to support the proper documentation of clinical services, the efficiency and quality of clinical care and the timely payment of claims in accordance with state and federal regulations. This position develops utilization review reports and tracks trends of findings. This position creates training resources, provides training and offers technical assistance. This position participates in quality management, quality improvement and performance improvement activities as assigned.
There is currently one full-time position available in the Behavioral Health & Recovery Services Division (BHRS).
Health and Human Services has embraced a hybrid work schedule that considers that some duties of this position may be performed remotely and options to telework up to three days per week and work remaining days onsite are available; however, the successful candidate must be able to report to County facilities for meetings, work assignments, and/or disaster service work upon short notice, as needed and deemed appropriate. While onboarding and training, the successful candidate may be required to work primarily onsite before establishing a hybrid work schedule.
ABOUT YOU
Our Highly Qualified Candidate:
The ideal candidate for this position will have knowledge and/or experience working with behavioral health documentation, regulatory requirements and data reporting related to utilization of services. The ideal candidate will have knowledge of DHCS (Department of Health Care Services) reviews and audits, and EQRO (External Quality Review Organization) reviews and CalAIM (California Advancing and Innovating Medi-Cal). They will be comfortable and skilled at developing and delivering trainings for professionals of varying backgrounds. They will be highly organized, dependable, accurate and able to work independently. They must be competent working with computers and electronic health records and be proficient in developing and maintaining systems to track detailed information. They should have excellent communication skills, good judgment and decision-making skills and the ability to build strong working relationships within the organization and the community.
We recognize your time is valuable, so please do not apply if you do not have at least the following required Minimum Qualifications:
Education:
Any combination of education that would provide the knowledge and skills listed. Typically, equivalent to either possession of a Master's degree from an accredited institution in social work, psychiatric nursing, psychology, counseling or a closely related field, or possession of a Doctoral degree in clinical psychology or a closely related field, or completion of three years of graduate education including completion of the doctoral-qualifying comprehensive examinations and a university-approved clinical internship equal to two full-time academic quarters (900 hours).
Experience:
Mental Health Practitioner:
Typically, equivalent to one year of clinical mental health experience under qualified supervision in a mental health setting. Experience must have included screening, diagnostic assessment and treatment in either an inpatient or outpatient setting for individuals with serious mental illness and/or serious emotional disturbance.
Licensed Mental Health Practitioner:
Typically, equivalent to two years of clinical mental health experience under qualified supervision in a mental health setting. Experience must have included screening, diagnostic assessment and treatment in either an inpatient or outpatient setting for individuals with serious mental illness and/or serious emotional disturbance.
Certificates and Licenses:
Mental Health Practitioner:
Must be eligible and sit for professional licensure as a Clinical Social Worker, Marriage and Family Therapist, Clinical Psychologist, Professional Clinical Counselor or Registered Nurse within timelines consistent with the California Welfare and Institutions Code. Failure to obtain licensure within the specified timelines will result in termination of employment.
Licensed Mental Health Practitioner:
Must be professionally licensed as a Clinical Social Worker, Marriage and Family Therapist, Clinical Psychologist, Professional Clinical Counselor or Registered Nurse in the State of California. Qualified non-California residents must obtain a California license within timelines consistent with the California Welfare and Institutions Code. Failure to obtain licensure within the specified timelines will result in termination of employment.
For more detailed information about this classification, including the minimum qualifications, please click here: class specification.
ABOUT THE PROCESS
All applicants will receive email notifications regarding their status in the recruitment process. Please be sure to check your spam settings to allow our emails to reach you. You may also log into your governmentjobs.com account to view these emails.
Testing and Eligible List:
Depending on the number of qualified applications received, the examination may consist of a highly qualified review, application screening, online assessment, written examination, oral examination, performance examination, or any combination to determine which candidates' names will be placed on the eligible list.
The eligible list established from this recruitment will be used to fill the current vacancy and any future vacancies for open, fixed-term, full-time or part-time positions which may occur while the list remains active.
SPECIAL REQUIREMENTS:
Candidates selected are subject to fingerprinting by the Sheriff's Department and must pass a Department of Justice LiveScan background check prior to appointment
IMPORTANT INFORMATION:
Pursuant to the Order of the Marin County Public Health Officer, it is required that all County employees confirm their vaccination status. Depending on work assignment and applicable Public Health Order, some employees may be required to be fully vaccinated and/or consent to weekly COVID-19 testing. To help mitigate transmission, an Order of the Marin County Public Health Officer requires all individuals to wear face coverings when indoors in workplaces and public settings.
Disaster Service Workers:
All County of Marin employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.