Sunday, August 25, 2019

Clinical Review Specialist

Recruitment #17-6515-01

Introduction

THIS IS A REOPENING OF AN EXISTING EXAMINATION.

If you have previously applied for or started an application for the Clinical Review Specialist, Examination #17-6515-01, and choose to reapply, you must contact the analyst at Nicole.Lewis-Bolton@acgov.org to have your previous application released back to you.  

The scores and dispositions of candidates for this examination will be merged with previous exam participants. If you have previously submitted an application and choose to reapply, your new score/disposition will replace your current score/disposition.

Applications must be in the possession of the Human Resource Services Department by 5:00 p.m. on the Last Day for Filing. Applications will only be accepted on-line.

 

Supplemental Questionnaire: A properly completed Supplemental Questionnaire must be submitted with each application. Applications and Supplemental Questionnaires must be in the possession of the Human Resource Services Department by 5:00 p.m. on the Last Day for Filing. Failure to submit the Supplemental Questionnaire will result in disqualification.

 

DESCRIPTION

THE COUNTY

Alameda County, located on the east side of San Francisco Bay, is California's seventh-largest county.  The County employs 9,080 full-time employees and operates on an annual budget of $2.39 billion.  Oakland, the County seat, is California's eighth largest city.  One and a half million people call Alameda County home and live in a variety of incorporated cities, unincorporated communities and rural areas.  As a major urban county, Alameda provides a full range of services to its citizens.  The County is a blend of culturally and ethnically diverse communities, and its mixture of cosmopolitan and suburban areas provides the perfect environment for families and their active lifestyles.  The County offers extensive cultural resources, countless recreational opportunities and an array of fine public and private colleges and universities. 

THE HEALTH CARE SERVICES AGENCY

Alameda County's Health Services Program is administered by the Health Care Services Agency and includes the following program areas: Behavioral Health Care, Public Health, Environmental Health, and Agency Administration/Indigent Health. The ultimate mission of the Health Care Services Agency is to provide fully integrated health care services through a comprehensive network of public and private partnerships that ensure optimal health and well-being and respect the diversity of all residents. Health Care Services Agency currently has multiple career opportunities for experienced professionals to become part of a service delivery team dedicated to the optimal health and well-being of Alameda County residents. 

 BEHAVIORAL HEALTH CARE

It is the mission of Behavioral Health Care Services to maximize the recovery, resilience and wellness of all eligible Alameda County residents who are developing or experiencing serious mental health, alcohol, or drug concerns. We envision communities where people realize their potential, and where stigma and discrimination against those with mental health, alcohol and/or drug issues are a thing of the past.

 Only through exemplifying the following Alameda County Behavioral Health Care Services values will we be successful:

 ACBHCS

Access - where every door is the right door for welcoming people with complex needs;

Consumer and Family Empowerment - through shared decisionmaking best practices, that clinically produce effective outcomes;

Best Practices - business excellence that uses public resources costeffectively;

Health and Wellness - by integrating emotional, spiritual and physical health care;

Culturally Responsive - appropriate services built on the strengths and life experiences of culturally diverse consumers and their families;

Social Inclusion - utilizing advocacy and education to eliminate stigma, discrimination, isolation, and misunderstanding of persons with mental illness and substance abuse.

 For more information about the department of Behavioral Health Care Services, please visit www.acbhcs.org/.

THE POSITION

Under general direction, Clinical Review Specialists provide behavioral health care services by telephone, face-to-face, and/or record review for referral, treatment, and/or payment authorization and service integration; gather and analyze case history data and treatment plans; make treatment recommendations and assess quality of care; record all findings and maintain review records; and perform related work as required.  Clinical Review Specialist positions are located in the Department of Behavioral Health Care Services ACCESS Program, Authorization Services and Quality Assurance. These positions provide a variety of clinical services including screenings and referrals, face to face assessments, review of medical necessity for authorization of services, utilization review, assessment of quality of care, and provider consultation.  

THE VACANCIES

The immediate vacancies for this position are in the ACCESS Program, Utilization Management Program, and Quality Assurance Office; however, please note that the eligible list resulting from this recruitment and selection process may be utilized for other future vacancies which may arise throughout Alameda County within the next year for this and other County Departments. 

ACCESS Program- We are currently seeking to hire one (1) Clinical Review Specialist within the ACCESS Program to serve as an initial point of public contact and provide telephone information, screening, assessment and referral services to the greater Alameda County community.  The licensed clinicians at ACCESS generally work in a call center setting, hear concerns over the telephone, provide clinical screenings, and make referrals to identified service providers within the County's network who can best meet the specific needs of each individual client, including language and clinical needs.  An ACCESS Clinical Review Specialist may also be placed in an alternative setting to provide face to face assessments and referrals. These positions authorize treatment; assess for level of care; maintain records; provide consultation concerning medical necessity and utilization of system resources; and provide telephone crisis intervention services including arranging for emergency services when needed.  Our current openings is for a Clinical Review Specialist for our child team.  We anticipate additional openings in the near future, including seeking licensed clinicians who have extensive Substance Use Disorder (SUD) experience.

Utilization Management Program (formerly Authorization Services)  -  We are seeking to hire at least one (1) Clinical Review Specialist within the Utilization Management Program to provide daily case consultation and chart review to determine medically necessary treatment and appropriate utilization of system resources for both inpatient and outpatient behavioral health services (including both mental health and substance use disorder). The licensed clinician is expected to consistently assess level of care, treatment and disposition plans based on cultural, developmental and age-related parameters; assure in each medical necessity review that adequate documentation exists to substantiate provision of services and payment authorization; and obtain information and documentation that is required to conduct pre-service, admission and continued stay hospital reviews including determination of aftercare planning and placement efforts.    

Quality Assurance  -  We are seeking to hire at least two (2) Clinical Review Specialists within Quality Assurance to assess the quality of care and documentation required to support continued client behavioral health care treatment (including both mental health and substance use disorder treatment); manage audits (internal, State and Federal); investigate complaints; review unusual occurrences; monitor compliance with regulations including, but not limited to: clinical documentation to Medicaid/Medi-Cal and Medicare standards, HIPAA, chart reviews, utilization reviews, grievance tracking/reporting, change of provider requests, site certification, and provider license verification; respond to provider questions about documentation standards, claiming, staff qualifications and other inquiries into regulations; revise and write manuals and procedures; work with other departments on Quality Assurance initiatives and special projects; and collaborate on and provide trainings to mental health and substance use disorder service providers on topics such as clinical documentation to Medi-Cal Specialty Mental Health Services standards and Drug Medi-Cal standards. Knowledge of ASAM levels of care useful.

IDEAL CANDIDATES

In addition to the minimum qualifications and knowledge and skills listed below, ideal candidates for these positions will be licensed clinicians with at least three (3) years of post-licensure clinical work experience within a health care call center, quality assurance or utilization review setting; and will have excellent communication and interpersonal skills to support their ability to interact well with others to earn their trust within an environment that embraces diverse cultures, interpersonal styles, abilities, motivations, and backgrounds.

Ideal candidates for these positions will also be highly respected as: 

  • Licensed and experienced clinical professionals who are adept at securing relevant client care data and identifying key issues and relationships in a behavioral health managed care setting; who understands the relationships among assessments, interventions, and patient responses; and who are skilled in conducting behavioral health assessments and utilization and quality assurance reviews in order to refer clients to or evaluate medical necessity of services within the Alameda County network of service providers.
  • Professionals who would take personal satisfaction and pride representing the County and serving as part of a team directly responsible for either providing initial clinical screening and service referrals over the telephone in a fast-paced, high volume call center environment or providing quality assurance and utilization review of clinical resources.
  • Resourceful and adept at seeking or collecting and synthesizing information from a variety of clients and sources in an objective, unbiased manner in order to reach a sound conclusion, goal, or judgment.
  • Collaborative spirits eager to actively participate as a member of a team contributing successfully to the completion of goals and objectives aligned with the mission, vision and values of the Behavioral Health Care Services system of care.
  • Practiced problem solvers capable of making well supported decisions by  identifying and understanding issues, problems, and opportunities; comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action; and solving problems by taking action that is consistent with available facts, constraints, and probable consequences.
  • Well organized, capable of multi-tasking and planning daily work activities, and establishing a course of action for self and others to ensure that work is completed efficiently.
  • An effective communicator who conveys information and ideas verbally and in writing in a manner that meets audience needs; and develops and maintains effective relationships with others by relating well to people with diverse cultures, interpersonal styles, abilities, motivations, or backgrounds.

For a detailed listing of the duties and essential competency requirements for this position, please see the complete job description.

MINIMUM QUALIFICATIONS

EDUCATION:
Possession of a Master’s Degree from an accredited college or university in Social Work, Marriage and Family Therapy, Psychiatric Nursing, with an emphasis in Clinical Social Work, or equivalent degree which meets requirements set by the California Board of Behavioral Sciences; OR A Ph.D. in clinical, counseling, or educational psychology from an accredited college or university. NOTE: Completion of an accredited registered nursing program, including three years post licensed nursing experience may be substituted for a Master’s degree in nursing.

AND

EXPERIENCE:
The equivalent of three years of full-time, paid post-license experience in direct behavioral health care that includes treatment and disposition planning and/or the clinical review of these direct mental health and substance use disorder services.

LICENSE/REGISTRATION:
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.
Possession of a valid California Motor Vehicle Operator’s license. Applicants must possess such license prior to appointment to such positions.

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.

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

KNOWLEDGE AND SKILLS

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

The most suitably qualified candidates will possess the following competencies:

Knowledge of:

  • Social and behavioral aspects of mental, emotional, substance use disorder (SUD)-related disturbances and their characteristics.
  • Principles and practices of direct client service delivery.
  • Scope, activities and functions of the various behavioral health facilities and public and private community agencies providing services to mental health and substance use disorder 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.
  • Computer applications related to the work.

Ability to:

  • Evaluate cases and perform advanced differential diagnosis of a mental disorder.
  • Evaluate cases and perform advanced clinical risk assessment.
  • Communicate effectively and document the biopsychosocial basis for triage, referral and authorization decisions.
  • Communicate effectively selection factors related to a broad range of behavioral health care intervention modalities.
  • Organize and prioritize work, and meet critical deadlines. 
  •  Maintain accurate records and files.
  • Input and/or access data via system-wide network computers and personal computers.
  • Prepare clear, accurate and effective reports, correspondence and other written materials.
  • Interpret, explain and apply complex regulations, policies and procedures.
  • Effectively utilize community resources in the care of individuals with mental or substance use disorders.
  • Establish and maintain effective working relationships with those contacted in the course of work.

EXAMINATION COMPONENTS

The examination will consist of the following steps: A review of candidates' applications to verify possession of minimum requirements. Those candidates who possess the minimum requirements for the class will move on to the next step in the examination process which is a review of candidates' Supplemental Questionnaires to select the best qualified applicants to continue in the process. Those candidates selected as best qualified will move on to the next step in the examination process, an oral interview which will be weighted as 100% of the candidate's final examination score. The oral interview may contain situational exercises.

CANDIDATES MUST ATTAIN A QUALIFYING RATING ON EACH PORTION OF THIS EXAMINATION.

We reserve the right to make changes to the announced examination components.

Alameda County utilizes a Civil Service Selection System founded on merit. Such a system is competitive and based on broad recruitment efforts and equal opportunity for qualified applicants to test in an examination process designed to determine the qualifications, fitness and ability of competitors to perform duties of the vacant position.  Many of our recruitments are targeted and specific to the needs of a current vacant position, in which case, the eligible list may be exclusively used for that current vacant position. Other recruitments may be more broadly used for both current and future vacancies, or for other alternate jobs with comparable scopes of work.

To learn more about our recruitment and selection process, please visit the “What You Need to Know” section of our website, www.acgov.org/hrs.

Selection Plan

Applicants will be informed via email with reasonable notice in advance of any examination process which will require their attendance.  The following dates are tentative and subject to change based on the needs of the Agency: 

 

TENTATIVE SELECTION PLAN:

Deadline for Filing

5:00pm, Monday, July 1, 2019 Friday, February 9, 2018

Review of Minimum Qualification

July 5, 2019 February 16, 2018

Supplemental Questionnaire Review for Best Qualified

July 30, 2019 March 6-9, 2018

Oral Interview Exam**

August 14-15, 2019 March 27-28, 2018

**The combined oral examination/hiring interview, in addition to establishing an eligibility list, may serve as the final selection interview for vacancies in this classification

 WE RESERVE THE RIGHT TO MAKE CHANGES TO THE ANNOUNCED RECRUITMENT & SELECTION PLAN  

Alameda County and the Human Resource Services Department will make reasonable efforts in the examination and/or selection process to accommodate qualified individuals with disabilities and/or medical conditions in accordance/compliance with the State Fair Employment and Housing Act (FEHA), Federal Americans with Disabilities Act (ADA) Alameda County’s Reasonable Accommodation Policy and applicable statues.  To request an accommodation due to a disability/medical condition during this or other phases of the examination/selection process, please contact the assigned Human Resources Representative listed on the job announcement before the last date of filing. Alameda County requires applicants to provide supporting documentation to substantiate a request for reasonable accommodation. In order to qualify for a reasonable accommodation, applicants must have a disability/medical condition pursuant to the ADA, FEHA and applicable statutes.

For more information regarding our Reasonable Accommodation procedures, please visit our website, www.acgov.org/hrs  

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) 
  • 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

  • 11 paid holidays
  • Floating Holidays
  • Vacation and sick leave accrual
  • Vacation purchase program
  • Catastrophic Sick Leave
  • Employee Mortgage Loan Program
  • Group Auto/Home Insurance
  • 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
  • 1st 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.

 

Conclusion

All notices related to County recruitments for which you have applied will be sent/delivered via email. Please add @acgov.org and alamedacountyHR@acgov.org as accepted addresses to any email blocking or spam filtering program you may use. If you do not do this, your email blocking or spam filtering program may block receipt of the notices regarding your application for recruitments. You are also strongly advised to regularly log into your County of Alameda online application account to check for notices that may have been sent to you. All email notices that will be sent to you will also be kept in your personal online application account. You will be able to view all of your notices in your online application account by clicking on the "My applications" button on the Current Job Openings page.

 

Please take the steps recommended above to insure you do not miss any notices about a recruitment for which you have applied. The County of Alameda is not responsible for notices that are not read, received or accessed by any applicant for a County recruitment.

 

NOTE: All notices are generated through an automated email notification system. Replies to the email box alamedacountyHR@acgov.org are routed to an unmonitored mailbox. All notices are generated through an automated email notification system. If you have questions please go to our website at www.acgov.org/hrs. You may also contact the Human Resources Analyst listed on the job announcement for the recruitment for which you have applied.

 

Nicole Lewis-Bolton, Human Resources Analyst II

Human Resource Services, County of Alameda

(510) 272-6468 • nicole.lewis-bolton@acgov.org

 

Alameda County has a diverse workforce, that is representative of the communities we serve, and is proud to be an equal opportunity employer.  All aspects of employment are based on merit, competence, performance and business need. Alameda County does not discriminate in employment on the basis of, race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factors protected under federal, state and local law. Alameda County celebrates diversity and is committed to creating an inclusive, and welcoming workplace environment.