Behavioral Health Operations Specialist II

Job Category: Clinical

Department: Behavioral Health

Location:

Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 8888

Salary Range: $67,186.00 (Min.) - $87,342.00 (Mid.) - $107,498.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Behavioral Health Operations Specialist II is responsible for supporting, coordinating and facilitating several areas of the Behavioral Health Department. This position will assist members with accessing Behavioral Health services and provide guidance and support to members encountering complex needs when navigating the health care system. This position will also provide support with collecting and analyzing data from behavioral health vendor, County Department of Mental Health, Public Health and direct Applied Behavioral Analysis (ABA) providers. This position will provide support with, submitting required reporting elements in a timely fashion to regulatory organizations. Furthermore, the behavioral health operations specialist will also facilitate providers with technical and logistical guidance when coordinating with internal and external stakeholders. This position will support the department with behavioral health related quality improvement, compliance, and regulatory support within the Behavioral Health Treatment Program and Clinical teams.

Duties

Day to Day vendor and member support including, but not limited to, trainings, education and information to vendors and responding to all vendor related inquiries.

Provides program support for the department to ensure successful development/implementation of existing and emerging initiatives. Coordinate and assist with logistics for assigned tasks/activities, develop written communications, presentations as needed.

Works collaboratively with the ABA and Clinical teams to ensure compliance and smooth business operations.

Analyzes and resolves complex problems dealing with grievances and appeals. Provide policy and procedure interpretation and implement processes. Coordinates and leads regular meetings with vendors, track and analyze metrics, lead solutions and review/audit files, to improve health outcome care measures and provide status reports to management and business partners.

Supports with Healthcare Effectiveness Data and Information Set (HEDIS), National Committee for Quality Assurance (NCQA) and QI reporting, audit preparation and data collection.

Works to support other Behavioral Health Department projects and initiatives.

Performs other duties as assigned.

Education Required

Associate's Degree

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Bachelor's Degree

Experience

Required:
At least 4 years of provider services/relations experience in a healthcare field, including behavioral health related field or medical group, knowledge of file review/auditing.

Experience providing excellent customer service.

Skills

Required:
Work proactively in collaborate team environment.

Strong organizational, multi-tasking and time management skills.

Strong written and verbal communication skills.

Ability to lead and present in small and large group settings.

Essential computer skills. Proficient with Microsoft Office, especially Word and Excel.

Ability to be flexible as position evolves with the needs of the department and new developments at the State and Federal level.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

L.A. Care offers a wide range of benefits including

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.