Mental Health Program Specialist - Behavioral Health Services Act (Open & Promotional)

About the role

Lead Medi-Cal billing and revenue cycle improvement initiatives.
Oversee initiatives focused on developing certification and billing infrastructure for contracted community-based providers.
Coordinate agency-wide requirements for implementation and fidelity monitoring of Evidence-Based Practices (EBPs).
Support implementation of Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) and other EBP and Medi-Cal billing-related initiatives.
Advise leadership on relevant policy changes to support strategic planning and sustainable, high-quality service delivery.

Responsibilities

• Serve as BHRS subject matter expert on Medi-Cal billing, reimbursement regulations, and revenue optimization strategies.
• Lead patient care revenue maximization initiatives focused on improving billing accuracy and maximizing allowable Medi-Cal reimbursement.
• Oversee initiatives focused on developing and implementing streamlined billing infrastructure for community-based organizations to optimize Medi-Cal-eligible services, peer supports, and community-defined evidence practices (CDEPs).
• Facilitate an Evidence-Based Practice (EBP) Committee to support EBP selection, review, and policy and procedure development.
• Work collaboratively with BHRS Program Managers and Quality Management team to ensure EBP implementation to fidelity in compliance with state and federal guidelines.
• Review EBP revenue generation, utilization and other relevant data and make recommendations for adjustments as necessary to optimize billing, cost recovery, and compliance.
• Prepare actionable reports, briefs, and presentations to inform executive leadership strategic planning and decision-making.

Requirements

The ideal candidate will demonstrate knowledge of Medi-Cal billing, managed care contracting, and behavioral health patient care revenue systems.
Demonstrated ability to analyze data and develop system-level recommendations for operational improvements.
Knowledge of BHSA, BH-CONNECT, California Advancing and Innovating Medi-Cal (CalAIM), and other State initiatives impacting Medi-Cal reimbursement and documentation standards.
Experience with implementation, readiness assessment, and fidelity monitoring of evidence-based practices (EBPs).

Qualifications

• Licensure/Certification: California license as one of the following: 1) Clinical Social Worker; 2) Marriage and Family Therapist; or 3) Clinical Psychologist.
• Education And Experience: Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. A typical way to qualify is three years of experience as a Mental Health professional.

Skills

• To Plan, assign, supervise, review and evaluate the work of interdisciplinary subordinates.
• Train staff in work procedures and provide technical and programmatic assistance to staff and subcontractors.
• Analyze, interpret and apply various regulations, requirements and/or clinical approaches.
• Prepare grant proposals and written reports.
• Set realistic treatment goals and facilitate their attainment.
• Evaluate patients/clients’ degree of mental disability or emotional distress.
• Communicate effectively in writing and orally and make public presentations as needed.
• Establish and maintain effective and cooperative relationships with those contacted in the course of the work.
• Exercise sound independent judgment within general policy and regulatory guidelines.

Benefits

Comprehensive and competitive benefits package including health and wellness programs, financial security, and professional development opportunities. For details, visit the Benefits-at-a-Glance page.

Pay

Details on pay scale and compensation will be provided upon successful completion of the examination process.

Schedule

The schedule for this position will be determined based on the needs of the department and the individual's qualifications and experience.