Medical Care Program Benefits Manager (#PJ8 )

$52.58-$69.88 hourly / $9,113.69-$12,112.30 monthly / $109,366.40-$145,350.40 yearly

• Plans, organizes, directs, administers and evaluates assigned health and mental health benefit programs and finances;
• Participates with Agency Director and Division Directors in the planning, implementation, and ongoing evaluation of the quality and effectiveness of client benefit services;
• Develops and manages budgets, contracts and financial reporting for mental health and substance abuse services and health benefits;
• Reviews staffing and resource needs;
• Acts as liaison for the health benefit program within the Health Services Agency, the Human Resources Agency, federal, state, and local government;
• Participates in inter- and intra-agency meetings and organizations to provide necessary health benefit and medical services to Agency clients;
• Prepares proposals for grants and funding sources to support and enhance health and medical benefits for Health Services Agency clients, and clients served by community agencies, schools, and community clinics;
• Conducts staff meetings to coordinate health benefit program resources, enrollment and retention procedures;
• Conducts long and short range planning for health benefits that include implementation of major new initiatives;
• Supervises; assigns and reviews work, resolves problems and interprets program policy;
• Conducts performance evaluations;
• Makes budget and staffing recommendations;
• Collects statistical data on health benefit program activities and prepares written reports, program summaries and correspondence as requested.

EMPLOYMENT STANDARDS
Knowledge:

• Working knowledge of theories, principles, goals, and objectives of health benefit programs and administration;
• Working knowledge of principles, practices, funding sources, laws and regulations, and administrative requirements in health, mental health and substance abuse programs;
• Working knowledge of principles, practices, and techniques of health and mental health benefit program planning, development, and evaluation;
• Working knowledge of principles and procedures of budget preparation and monitoring, including budgets involving grants, contracted services, and state and federal funding;
• Working knowledge of contract administration principles and practices;
• Working knowledge of cost reports and audit procedures;
• Some knowledge of governmental medical care systems, regulations and procedures governing health benefit programs and services;
• Some knowledge of information systems and software to support health program functions;
• Some knowledge of public assistance and social service agencies and medical or welfare eligibility systems;
• Some knowledge of public relations;
• Some knowledge of legal and billing issues associated with health benefits programs and insurance;
• Some knowledge of data and administrative systems used in health.

Ability to:

• Plan, organize, coordinate, and evaluate complex health and mental health program, fiscal and administrative activities and diverse staff;
• Train, supervise, and evaluate the work of staff;
• Develop and monitor short and long range budget plans that accurately reflect health benefit program needs;
• Identify the need for and develop proposed changes in current program practices, policies, and procedures;
• Build and sustain coalitions to promote health, mental health and substance abuse resources in the community;
• Exercise sound judgment in solving administrative and technical problems within program guidelines;
• Establish and maintain effective public relations with health benefit program clients and contract service providers;
• Collect and analyze statistical data;
• Direct cost reports, claims, and audits for mental health and substance abuse;
• Conduct public relations on behalf of the Health Services Agency on issues related to mental health and substance abuse finance and administration, as well as health insurance, enrollment, and policy;
• Prepare written reports and correspondence.

Training and Experience: Any combination of training and experience that would provide the required knowledge and abilities is qualifying.

Typical ways to acquire the knowledge and abilities would be:

Possession of a Bachelor’s Degree from an accredited college or university in health care administration, a public health field, health science, or in a management field such as public or business administration,
AND
Six years of experience in a health care or medical social services organization performing supervision, program coordination, or program management.

Special Requirements:
Possession and maintenance of a valid California Class C driver’s license or the ability to provide suitable transportation approved by the appointing authority;

Physical and mental capability to performing the position’s essential functions as summarized in this specification’s Typical Tasks section.

EST: 2/84 REV: 11/04, 6/04 Analyst: GLD