County of Alameda

Authorization Services Coordinator (#5342)

$54.74-$65.77 Hourly / $4,379.20-$5,261.60 BiWeekly /
$9,488.27-$11,400.13 Monthly / $113,859.20-$136,801.60 Yearly


DESCRIPTION
Under general direction, to direct, coordinate and supervise the County's effective and efficient use of resources in providing behavioral care services that will ensure optimal reimbursement from Medicare, Medi-Cal, and other payers of these services; and to do other related work as required.

DISTINGUISHING FEATURES

This single-position classification is located in the Behavioral Health Care Services Department of the Health Care Services Agency and reports to the Deputy Director, Behavioral Health Care Services.

The Authorization Services Coordinator directs, coordinates and manages all aspects of the Authorization Services Program. This position is distinguished from the lower class of Clinical Review Specialist Supervisor in that the latter class supervises staff but does not have responsibility for the overall management of the unit. This class is further distinguished from the next higher class of Quality Management Program Director in that the latter class serves in a leadership role in developing and implementing quality improvement programs and policies for Behavioral Health Care Services.

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. Directs, coordinates and supervises the Authorization Services Program; supervises unit staff and operations; and monitors related contracts.

2. Develops and interprets operational standards and procedures for the Authorization Services Unit.

3. Develops and implements guidelines, consistent with State and third party payor standards, for payment authorization of hospital and non-hospital behavioral health care services.

4. Develops and implements a reporting system for tracking utilization patterns for individual clients, individual providers, and the service system as a whole. Collaborates with the Information Systems and Data Analyst staff to develop the technical capacities needed to keep management adequately informed of utilization patterns and issues.

5. Makes recommendations to Behavioral Health Care Services Administration regarding program developments related to improving service utilization.

6. Provides consultation and clinical service recommendations to service providers.

7. Develops and implements a system for gathering and reporting selected quality of practice information in collaboration with the Quality Assurance Administrator.

8. Serves as representative and liaison to State Departments and other programs responsible for oversight of payment authorization practices at local health care system level.

9. Provides consultation and recommendations regarding related policy, procedures and program design to Administration.


MINIMUM QUALIFICATIONS
Either I

Experience:

The equivalent of two years of full time experience in the class of Clinical Review Specialist Supervisor in the Alameda County classified service (Non-classified includes District Attorney’s Office, Hospital Authority, and the Consolidated Courts).

Or II
Education:

Possession of a Master’s degree from an accredited college or university in a health care field, such as social work, counseling, psychology, nursing, health care services administration or a related field.

AND
Experience:

The equivalent of three years of full-time administrative clinical experience of which at least one year was in a supervisory capacity.

License/Certification:

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

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 and abilities are related to duties listed under the "Examples of Duties" section of this specification.

Knowledge of:

• Principles and techniques of effective supervision.
• Medical terminology and hospital procedures.
• Federal and state regulations for Medicare and Medi-Cal and fiscal intermediary provisions related thereto.
• Principles and techniques in receiving optimal reimbursement.

Ability to:

• Communicate effectively orally and in writing.
• Make decisions.
• Analyze and problem solve.
• Plan and organize.
• Analyze budgets.
• Manage resources.
• Demonstrate leadership.
• Demonstrate interpersonal sensitivity.

CLASS SPEC HISTORY
TT:lm 2/3/75-hg
TMZ:pb Revised: 2/2/87
Old doc: 0451h
New doc: Jobspecs/5342
ys/6/01
CSC Date: 3/11/87
ABS:po Revised/Retitle 4/16/09
old title: Utilization Review Coordinator
CSC Date: 5/6/2009
SP:cs Revised 7/21/15
CSC Date: 8/5/15

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

  • 11 paid holidays
  • Floating Holidays
  • Vacation and sick leave accrual
  • Vacation purchase program
  • Management Paid Leave**
  • 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.

** 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.