Behavioral Health Services Coordinator II

Job Summary

The Behavioral Health Services (BHS) Coordinator II supports the department by assisting with the various Behavioral Health initiatives and programs in handling the administrative functions of the behavioral health services/ continuity of care/specialty liaison process including intake, logging, tracking and status follow-up on cases. This position assists members with accessing the Behavioral Health services to ensure services can be accessed in a timely manner to comply with any regulatory requirements and/or timelines. This includes coordinating with members, community providers, internal departments at L.A. Care, and any additional vendors. In addition, this position handles and coordinates the identification, documentation, evaluation and resolution of behavioral health services. This position works in a team environment on the planning, coordinating and evaluating of programs and activities related to Behavioral Health Services. This position professionally and efficiently handles Behavioral Health Services intake activities and accurately documents all activities per department policy, including entry into L.A. Care systems, and maintains confidentiality of member information.

Duties

Provides non-clinical support to the Behavioral Health Department that includes the technical aspects of the time sensitive processes for initiating cases, managing referral documentation, referrals, entering pre-certification/continued authorizations, identifying and responding to urgency of the request, appropriate documentation, case routing and tracking, routing of information, performing computer data input, faxing, filing of confidential member information, and maintaining logs of activity, etc. Serves as the main point of contact for internal and external customers and manages professional relationships with a proactive, hands-on approach. (35%)

Assists with non-clinical coordination of care to facilitate connecting members to care in the appropriate delivery system or provider to meet their needs. Collaborates with community providers as it relates to educating, offering guidance, and coordinating care to assist with connecting members to services. Conducts follow-up calls to members to administer screening or obtaining clarification on services requested or intake requirements. Works collaboratively with other Behavioral Health staff to research and resolve member and provider issues. (35%)

Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of job functions. Assists with special projects, data collection, calendaring, scheduling meetings and appointments. Coordinates meetings, creates agendas and takes meeting minutes. When necessary, facilitates meetings with providers as it relates to coordinating members care and ability to access services. (10%)

Maintains regular reporting responsibilities of care coordination activities. Ensures Behavioral Health-related complaints and grievances are addressed timely and tracked regarding eligibility determinations, assessments, and care delivered by L.A. Care's contracted providers.  (5%)
 

Follows policies, procedures and systems process to identify L.A. Care members’ eligibility. Adheres to policy for transmitting data and sharing confidential member information as it relates to the members’ care between L.A. Care departments and the community providers. (10%)

Performs other duties as assigned. (5%)

Duties Continued

Education Required

Education Preferred

Experience

Required:

At least 1 year of managed care or health care experience and/or working with members with behavioral health needs and/or any disadvantaged/under represented ethnic populations and/ or working in the non-profit, medical, or clinical sectors, case management information technology systems.

Skills

Required:

Knowledge of local community based organizations, agencies and community services.

Knowledge of developmental disorders and/or Applied Behavior Analysis services.

Knowledge of medical terminology and ICD-10 and CPT codes.

Strong verbal and written communication skills.

Proficiency with Microsoft Word, Excel, and Access.

Excellent organizational, interpersonal and time management skills.

Must be detail-oriented, a team player, and proactively work in a collaborative team environment.

Ability to interface with members, medical personnel, and other internal and external agencies and encourage others to comply with L.A. Care requirements and provide information in a timely fashion.

Preferred:
Bilingual in one of LA Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information