Experience Inc. Jobs

DEPARTMENT: Behavioral Health/Developmental Programs

UNION:     84

FLSA STATUS: Non-Exempt

GRADE:     41

REPORTS TO: Managed Care Adult Services/Program Development Director

This is a supervisory position responsible for performing professional work in the field of behavioral health (Mental Health and Drug/Alcohol) for individuals covered by HealthChoices Medicaid or eligible for HealthChoices Medicaid.  This position and its supervisory duties require clinical skill, employee initiative, knowledge of the Medicaid behavioral health system and services and the ability to act independently. This position manages the work performed by the Managed Care Adult Program Specialist I. Work is performed under the supervision of the Adult Services and Program Development Director. The position supports the work in compliance with state, federal and program specific regulations and requirements.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Functions as supervisor of the Managed Care Adult Program Specialist I as that position assumes the role of Department liaison in key adult services provided by the HealthChoices Behavioral Health Medicaid program. 
• Acts in partnership with the contracted Behavioral Health Managed Care Organization (BHMCO) to ensure quality and compliance of the adult services within the Behavioral Health HealthChoices program. 
• Supports Managed Care Adult Services and Program Development Director in oversight and integration of Medicaid-funded Behavioral Health Adult and Transitional Aged Youth Services, in their roles with Other Human Services Departments, including Mental Health/Developmental Base-Funded Programs, Area Agency on Aging, Housing, Children and Youth, Adult Probation and Parole, the criminal justice system and Single County Authority (SCA).
• Under direction of the Managed Care Adult Services and Program Development Director, delegates responsibilities and manages Managed Care Adult Program Specialist I in role as Department Liaison to BHMCO Community Outreach Coordinator.
• Supervises Managed Care Adult Program Specialist I in role as Department Liaison to cross-systems partners collaborating in key adult services provided by the HealthChoices Behavioral Health HealthChoices program.
• Oversees and manages Adult Systems Integration Facilitation (SIF)
• Scheduling and facilitation of meetings for SIF clients 
• Collateral calls with providers, services, and supports member is engaged with in an effort to best support the member
• Landlord engagement in very specific cases
• Coordination and oversight of teams for each member and follow-up on action items
• Sellersville Senior Apartments: Oversight of Managed Care Adult Program Specialist I as Department Liaison for HealthChoices recipients to ensure provision and accountability of adequate HealthChoices supports for those housed in Reinvestment-funded Housing Programs.
• Incorporates the input of stakeholders in the development of policies, initiatives and program development impacting adults served in our system.
• Under supervision of Adult Services and Program Development Director, assists in the oversight of Reinvestment-funded programs and/or new program start-up activities relating to Drug and Alcohol Services, Mental Health services and Community Based Organizations (BCOs) performing work related to Social Determinants of Health (SDOH). Activities may include:
• Oversight of contractors in implementation of a reinvestment plan
• Attendance at Regional coordination meetings
• Assurance of quality and care coordination of the individuals served in the plan
• Functioning as primary contact with Behavioral Health Managed Care Organizations (BHMCOs) and the Single County authority (SCA), Bucks County Drug and Alcohol Commission (BCDAC).
• Under supervision of Managed Care Adult Services and Program Development Director, delegates responsibilities and manages the Managed C re Adult Program Specialist I in the oversight of complex case services, including, but not limited to the following:
• Community Hospital Integration Projects Program (CHIPP): Oversight of the BHMCO contractor in the treatment and Care Coordination of the CHIPP members discharged from Norristown State Hospital.
• Act as primary facilitator with BHMCO Care Management in case coordination 
• Collaborate with County colleagues as needed on programs and services related to individuals discharging from Norristown State Hospital
• Under direction of Managed Care Adult Services and Program Development Director, attend or delegate Regional coordination meetings and ensure safety and quality oversight of CHIPP/HealthChoices members.
• Center Of Excellence (COE): Oversees the BHMCO contractor in the treatment and Care Coordination related to COE's:
• Attends Regional coordination meetings
• Ensures quality and care coordination of the individuals served in the COE's
• Acts as primary facilitator with BHMCO Care Management in case coordination.
• Participates regularly in BCBHS team and staff meetings as directed by supervisor.
• Prepares correspondence and reports as required.
• Attends conferences, meetings and/or training as requested by supervisor.
• Occasionally works evening hours or weekends as required.
• Local and regional travel occasionally required.
• Performs other work as assigned by Managed Care Adult Services and Program Development Director.

QUALIFICATIONS REQUIRED:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Any combination of experience and training affords the applicant an opportunity to gain the above listed knowledge, skill and ability.

REQUIRED KNOWLEDGE AND SKILLS:

• One (1) year as a County Program Specialist I with Mental Health and/or Substance Use experience OR Three (3) years of professional level experience in the field of Adult Managed Care and a bachelor's degree.
• Ability to establish and maintain effective working relationships with Department staff and behavioral health system partners.
• Ability to make clear and pertinent statements orally and in writing.
• Knowledge of basic principles and methods of working with adults and children with mental illness.
• Knowledge of substance abuse resources, Department of Humans Services/Medical Assistance application information and other County Human services resources.
• Knowledge of the structure, organization and methods of public and private behavioral health agencies.
• Knowledge of basic methods and principles of community organization.

PREFERRED KNOWLEDGE AND SKILLS:

Master's Degree and two (2) years of professional level experience in the field of behavioral health or any equivalent combination of experience and training.

Experience with Mental Health and Substance Abuse Services in the Medical Assistance PA HealthChoices Program.

Experience managing a Behavioral Health program against program standards and requirements preferred.

Project Management experience and the abi