Bargaining Unit: SEIU 1021 - Social Workers (005)
$57.39-$67.66 Hourly / $4,304.25-$5,074.50 BiWeekly /
$9,325.88-$10,994.75 Monthly / $111,910.50-$131,937.00 Yearly
Under general direction, to provide behavioral care services by telephone, face-to-face, and/or record review for referral, treatment, and/or payment authorization and service integration; to gather and analyze case history data and treatment plans; to make treatment recommendations and to assess quality of care; to record all findings and maintain review records; and to do 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.
This is a journey level class, requiring a licensed professional, fully trained and professionally skilled upon entrance into the class. This position reports to a licensed clinical manager. Direct supervisory review and guidance is provided only in selected cases. Clinical Review Specialists provide behavioral care clinical assessment, clinical analysis, referral for treatment, treatment review, and provider consultation involving considerable latitude and independence of judgment. Incumbents in this class may lead and consult with other staff on clinical issues but do not have formal supervisory responsibility.
The class is distinguished from Behavioral Health Clinician II, Clinical Psychologist and Clinical Nurse II positions in that incumbents usually perform tasks using indirect information but may use direct interactions to provide behavioral health screenings and referrals, level of care assessments, or clinical direction to other licensed professionals and a large network of independent practitioners and organizations. This direction may include payment authorization, resource utilization management, quality improvement, quality assurance and coordination of multiple funding sources to support treatment requests.
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.
4. Provides consultation concerning medical necessity and utilization of system resources.
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;
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.
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.
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.
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.
• 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.
• 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.
CLASS SPEC HISTORY
CSC Date: 12/20/00
TE:sw Revised 10/13/05
CSC Date: 12/21/2005
SG:po Revised 7/16/09
CSC Date: 8/12/09
RY:cs Revised 5/29/13
CSC Date: 6/26/13
SP:cs Revised 1/21/15
CSC Date: 2/18/15
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
For your Financial Future
For your Work/Life Balance
*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.