Supervisor, Behavioral Health (ABA)

Job Description
Department(s): Behavioral Health Integration (BHI)
Reports to: Manager Behavioral Health
FLSA status: Non-Exempt
Salary Grade: M - 85,000 - 141,086


About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About the Position

The Supervisor Behavioral Health will be responsible for the daily operation of Behavioral Health Treatment (BHT) services, including Applied Behavior Analysis (ABA), under Early and Periodic Screening Diagnostic and Treatment (EPSDT). The incumbent will oversee the benefit's prior authorization process and ensure members receive appropriate provider linkage. The incumbent will be responsible for the direct supervision and oversight of the BHT staff. The incumbent will work under the direction of the Manager, Behavioral Health to implement processes to ensure effective delivery of BHT/ABA services. The incumbent will be accountable for establishing and achieving quality and productivity standards and ensuring compliance with department policies and procedures. The incumbent will collaborate with other internal CalOptima Health departments to ensure all regulatory requirements are met. The incumbent will interact with contracted organizations and providers, health networks and other stakeholders in a manner that promotes collaborative working relationships.


Duties & Responsibilities:

• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Assists with hiring, managing, training, reviewing and setting goals for department and staff.
• Oversees and monitors the prior authorization process of the benefit and regulatory compliance.
• Provides direct oversight of the day-to-day operations of the BHT/ABA benefit.
• Participates and prepares for regular internal and external audits.
• Facilitates BHT/ABA staff meetings, including individual supervision.
• Provides clinical support for cases with complex behavioral health needs.
• Oversees provider case conferences to identify or clarify issues regarding a member's status, needs and goals; reviews activities, including progress and barriers towards goals; maps roles and responsibilities; resolves conflicts or strategizes solutions; and adjusts current service plans.
• Participates in the development, implementation and improvement of departmental policies, procedures and workflows.
• Develops and prepares reports to meet internal, regulatory, contractual and accreditation requirements.
• Maintains current knowledge of regulatory requirements pertinent to BHI Utilization Management which includes the Department of Health Care Services (DHCS), Centers for Medicare & Medicaid Services (CMS), Managed Risk Medical Insurance Board (MRMIB) and Department of Managed Health Care (DMHC).
• Ensures compliance with federal, state and county contracts and/or Memorandum of Understanding (MOUs) and other requirements set forth by regulatory agencies or funding sources specific to behavioral health care services.
• Acts as a liaison to community based and governmental providers that serve members.
• Completes other projects and duties as assigned.

Experience & Education:

• Master's degree in Social Work, Psychology, Marriage and Family Therapy, Education or related field required.
• Board Certified Behavioral Analyst (BCBA) or Board-Certified Behavioral Analyst - Doctoral (BCBA-D) required.
• 3 years of experience providing ABA services at a BCBA level required.
• 2 years of supervisory/management experience required.
• Experience in behavioral health audits, including CMS, DHCS, DMHC and NCQA, required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications:

• 2 years of utilization management experience.
• 2 years of managed care experience.

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical demands: While performing duties of the job, employee may be required to move about the organization, as well as to offsite locations. Employee must be able to sit for extended periods of time, as well as work at the computer for long periods. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Must also be able to reach with hands and arms and must occasionally lift office supply boxes, up to 25 pounds. Employee must be able to communicate, particularly for regular phone use, in meetings and face-to-face interaction. Employee may travel offsite to health networks/physician medical groups, hospitals, other ancillary providers, local meetings and health care delivery organizations, as needed.

• Work Environment: Typical office environment with minimal to moderate noise levels and controlled office temperatures. Visits to provider offices are equivalent to a typical physician's office, hospital, or other ancillary provider.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

Job Location: Orange, California
Position Type:

To apply, visit https://jobs.silkroad.com/CalOptima/Careers/jobs/4335

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