County of Alameda

DESCRIPTION

Under general direction manages and monitors acute, sub-acute, and crisis system resources and authorizes services for adults or adolescents on involuntary psychiatric holds or in need of acute psychiatric care; provides oversight of high level behavioral health services provided by community-based organizations; ensures appropriate levels of care that meet clinical quality of care standards; facilitates treatment and discharge plans with other system partners such as Social Services Agency, Probation Department, Sheriff’s Department, the Regional Center and other hospitals as appropriate.

 

DISTINGUISHING FEATURES

 

The Critical Care Manager, BHCS, is a licensed clinical professional, fully-trained and professionally skilled upon entrance into the classification. The work is generally performed in an urgent or emergency care setting and other sites where travel may be required. This position has extensive contact with County and contract service providers who provide clinical services to Behavioral Health Care Services (BHCS) clients.

 

This class is distinguished from other clinical classes in that the Critical Care Manager, BHCS is responsible for administrative and managed care tasks that entails a high level of influence and authority in making decisions that shape policy and procedures concerning acute and sub acute care services.  The responsibilities include providing  technical and clinical direction to other professionals and acting as a liaison to other clinical classes who provide direct service delivery.  Critical Care Managers report directly to a System of Care Director (Director, Children and Youth Services, Adult Services System of Care Director, Older Adult System of Care Director, or Transitional Age Youth System of Care Director).

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. Reviews involuntary psychiatric hold evaluations to ensure program participants/clients are seriously emotionally disturbed (SED) or seriously mentally ill (SMI).



2. Monitors and reviews utilization of facility beds and crisis stabilization, strategically addresses imbalances between supply and demand for services.



3. Provides regular reports on utilization and client flow patterns, identifies gaps in the system and recommends solutions.

4. Reviews and monitors admission and continued services funded through Behavioral Health Care Services according to established procedures; makes clinical decisions and policy recommendations concerning reimbursement and use of County resources in order to balance regulatory requirement and utilization of limited resources.



5. Provides information, consultation, and guidance to program staff as needed to enhance redirection of participants to other less restrictive services.



6. Reports to BHCS executive management team on quality of care, program operation, and policy issues on an ongoing basis.



7. Develops relationships with providers that support integration of services and efficient management of resources; assists providers on program design and capacity management.



8. Ensures reasonable and appropriate implementation of contract provisions as delineated in signed agreements between BHCS and community-based organizations providing services.



9. Assist providers in working with families, County, and community partners to establish appropriate ongoing placements.



10. Maintains regular and consistent communication with the BHCS Authorizations Unit and Quality Assurance Office regarding the authorization and level of services.



11. Participates in designated administrative and clinical meetings regarding client utilization and flow patterns within the system of care.



12. Provides reports and recommendations concerning resource development, system needs, and procedural changes to optimize the delivery of behavioral health services.



13. Provides technical assistance, case consultation and case review to determine medical necessity and appropriate utilization of system resources.



14. Makes authorization and other review determinations based on knowledge of cultural, developmental, and age-related issues.



15. Performs other duties as assigned within the classification.

MINIMUM QUALIFICATIONS

Education:

 

Possession of a Master’s Degree or higher from an accredited college or university in a mental health care field.

 

AND

 

Experience:

 

The equivalent of three years of full-time, paid  post-license experience in direct behavioral health care service delivery that included psychiatric diagnosis, treatment and disposition planning and or the clinical review of these direct behavioral health care services.

 

 

License:

 

Possession of   a valid clinical license from the applicable licensing authority: California Board of Behavioral Sciences, California Board of Psychology, or California Board of Registered Nursing.

 

Positions in this class require a valid California Motor Vehicle Operator's license. Applicants must possess such license prior to appointment.

 

Special Requirement:

In compliance with the Administrative Simplification provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), employees in this classification are required to possess a National Provider Identifier (NPI) number prior to their first day on the job.

In compliance with the Department of Health Care Services (DHCS) and the Federal Cures Act, Employees in this classification who are required to render direct specialty mental health services in the course of their assignment must successfully be enrolled in Provider Application and Validation for Enrollment (PAVE) web portal pri5384or to commencing employment.

KNOWLEDGE AND SKILLS

Knowledge of:

 

·       Social and behavioral aspects of mental and emotional disturbances and their characteristics

·       Principles and practices of direct client service delivery

·       Scope, activities, and functions of various behavioral health facilities and public and private community agencies providing services to mental health clients

·       Policies, procedures, and systems related to Behavioral Health Care Services, legal and regulatory requirements and limitations

·       Applicable federal, state, and local laws, rules and regulations

·       Funding sources and administrative requirements in the program area to which assigned

·       Principles and practices of program planning and evaluation

·       Programmatic analysis and report preparation

 

Ability to:

 

·       Organize and prioritize work to meet critical deadlines

·       Communicate effectively orally and in writing

·       Interpret, explain, and apply complex regulations, policies, and procedures

·       Plan, monitor, and evaluate program and service delivery in the programmatic area to which assigned

·       Exercise sound independent judgment within established policies and guidelines

·       Establish and maintain effective working relationships with those contacted in the course work

·       Make effective presentations to diverse groups

·       Represent the department and the County in meetings with others

CLASS SPEC HISTORY

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.