County of Alameda

DESCRIPTION

Under general direction of the Financial Services Officer in the Provider Relations Office, the Client Benefits and Accounts Manager provides supervision of financial, administrative, and operational support services for the Benefits and Eligibility Unit for Alcohol & Other Drug (AOD), Mental Health (MH), and Substitute Payee Programs; as well as performs other related work as required.


DISTINGUISHING FEATURES

This is a unique classification within the Department of Behavioral Health Care Services, Finance Division, in the Provider Relations Office. This position oversees, through Patient Services Supervisors, two units within the Provider Relations Office; the Benefits and Eligibility Unit which is responsible for client benefits enrollment and eligibility and the Substitute Payee Program Unit which is responsible for client account management.

EXAMPLES OF DUTIES

NOTE: The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Each individual in the classification does not necessarily perform all duties listed.

1. Plans, supervises, reviews and evaluates the work of management staff directly, recommends selection of new staff; recommends and implements discipline as required.

2. Oversees the functions of the Benefits and Eligibility Unit responsible for initial and ongoing client financial benefit enrollment and eligibility management for the Behavioral Health Care Services (BHCS) system of care which includes the maintenance of Medi-Cal and other benefit plans. Provides consultation, technical assistance and support to providers and BHCS administration on client-benefit programs and/or issues.

3. Oversees the functions of the Sub-Payee Program unit responsible for the management of conserved clients income and disbursement of payments as requested by Mental Health Case Managers and coordinates the management of the program as State and Federally mandated providing consultation and support to providers and BHCS administration on conserved client benefits and account management.

4. Acts as liaison with County operated sites, BHCS ACCESS referral unit and Authorization Unit, Community Based Organizations (CBO) and individual contracted providers in regards to client financial program eligibility, development of policies, training, monitoring, and consulting.

5. Acts as liaison with State Medi-Cal Third Party unit on the maintenance of client eligibility data in the state Medi-Cal eligibility system. Attends state meetings and conference calls for program updates, changes and enhancements as dictated by the State translating changes into policy or information sharing with staff and contractors.

6. Acts as liaison with private insurance benefit plans on the coordination and recording of client benefits within BHCS client accounting system. Acts as a consultant during BHCS private insurance contract processes.

7. Develops and implements policies and procedures for maintenance of client eligibility and insurance benefit records in the claiming software system.

8. Serves as the State designated Medi-Cal eligibility System Administrator for Alameda County Behavioral Health Care Services Department; manages the department’s access to State eligibility files, system security compliance, staff training and monitoring, and adherence to mandated State policies and procedures.

9. Participates in software system user groups, interacts with other County and State workgroups.

10. Acts as System Administrator for the Substitute Payee software system and liaison with the software vendor.

11. Monitors the monthly update of any eligibility or benefit plan input and coordinates and schedules related processing by Information Systems operations staff.

12. Collaborates with BHCS Administration on Health Care Services Agency with BHCS Health Programs of Alameda County (HealthPAC) indigent client benefit plan enrollment and maintenance.

13. Collaborates with the BHCS Provider Relations Billing Unit and Claims Processing Managers on client benefit plans to ensure appropriate claiming of all system of care services.

14. Performs other related work as required.

MINIMUM QUALIFICATIONS

Either I
Experience:

The equivalent of two years of full-time experience in the class of Patient Services Supervisor, Supervising Health Insurance Technician, or Supervising Eligibility Technician in the Alameda County classified service. (Non-classified includes District Attorney’s Office, Hospital Authority, and the Consolidated Courts.)

Or II
Experience:

The equivalent of four years of full-time client benefit plan enrollment and Medi-Cal eligibility experience, two years of which must be supervisory experience.

(Possession of a Bachelor’s degree in business or public administration, a social science or a field related to the work may substitute for two years of the experience).

License:

Possession of a valid California Motor Vehicle Operator’s license.

NOTE: The Civil Service Commission may modify the Minimum Qualifications in the announcement of an examination.

KNOWLEDGE AND SKILLS

NOTE: The level and scope of the following knowledge and abilities are related to duties listed under the “Examples of Duties” section of this specification.

Knowledge of:

• Supervisory principles, including work planning, direction, review and agency personnel policies.
• Practices and techniques of administrative analysis and report preparation.
• Applicable federal, state and local policies and regulations.
• Health care and health insurance systems and operations (e.g. Medicare, Covered California, Medi-Cal, Healthy Smiles, California HealthCare for Indigent Program, Kaiser Child Plan, and Alliance Family Care).
• Various benefit programs administered by the Social Services Agency and other State and Federal programs.
• Client and Public Relations.
• Computer applications related to the work.
• Office administrative practices and procedures, including records management and the operation of standard office equipment.
• Health insurance application and eligibility requirements, policies, procedures and provisions. Federal, State and local rules and regulations as they relate to billing for services.
• Methods and techniques of conducting client interviews.


Ability to:

• Plan, supervise, review and evaluate the work of others through subordinate supervisors.
• Train others in work procedures.
• Plan and conduct administrative and operational studies.
• Interpret, explain and apply complex policies, regulations and procedures, related to insurance programs.
• Prepare clear and accurate reports, correspondence, procedures and other written materials.
• Exercise sound independent judgment within established policies and guidelines to evaluate alternative and reach sound conclusions.
• Establish and maintain effective working relationships with those contracted in the course of the work.
• Prepare clear and accurate reports, correspondence, procedures and other written materials.
• Represent the department and the County in all meetings with others.
• Organize and prioritize work and meet critical deadlines.
• Maintain accurate records and files.
• Communicate clearly and effectively, both orally and in writing.

CLASS SPEC HISTORY

Newspecs: 1500
SP:cs 10/15/15
CSC Date: 11/24/15

BENEFITS

Alameda County offers a comprehensive and competitive benefits package that affords wide-ranging health care options to meet the different needs of a diverse workforce and their families. We also sponsor many different employee discount, fitness and health screening programs focused on overall well being.  These benefits include but are not limited to*:

For your Health & Well-Being

• Medical – HMO & PPO Plans
• Dental – HMO & PPO Plans
• Vision or Vision Reimbursement
• Share the Savings
• Basic Life Insurance 
• Supplemental Life Insurance (with optional dependent coverage for eligible employees)
• Accidental Death and Dismemberment Insurance 
• County Allowance Credit
• Flexible Spending Accounts - Health FSA, Dependent Care and Adoption Assistance
• Short-Term Disability Insurance
• Long-Term Disability Insurance
• Voluntary Benefits - Accident Insurance, Critical Illness, Hospital Indemnity and Legal Services
• Employee Assistance Program

For your Financial Future

• Retirement Plan - (Defined Benefit Pension Plan)
• Deferred Compensation Plan (457 Plan or Roth Plan)

For your Work/Life Balance

• 12 paid holidays
• Floating Holidays
• Vacation and sick leave accrual
• Vacation purchase program
• Management Paid Leave**
• Catastrophic Sick Leave
• Pet Insurance
• Commuter Benefits Program
• Guaranteed Ride Home
• Employee Wellness Program (e.g. At Work Fitness, Incentive Based Programs, Gym Membership Discounts)
• Employee Discount Program (e.g. theme parks, cell phone, etc.)
• Child Care Resources
• 1^st United Services Credit Union 

*Eligibility is determined by Alameda County and offerings may vary by collective bargaining agreement.  This provides a brief summary of the benefits offered and can be subject to change.

** Non-exempt management employees are entitled to up to three days of management paid leave. Exempt management employees are entitled to up to seven days of management paid leave.