Medi-Cal Transformation Manager (Manager III)

Job Description:

Medi-Cal Transformation Manager (Manager III)

Description

About the Opportunity

THE IDEAL CANDIDATE We seek an individual with experience in behavioral health and medical disorders, demonstrating expertise and professionalism in cross-system collaboration, partnership building, service quality improvement, and effective project management. The candidate should have a level of expertise and professionalism that leads and focuses on improving the quality of services for incarcerated persons. THE POSITION Under general direction, to achieve and maintain compliance with the California Department of Health Care Services (DHCS) requirements for the Medi-Cal Transformation Justice-Involved Initiative pertaining to reentry services and coordination within the Stanislaus County Sheriff’s Office and Probation Department. The Medi-Cal Transformation Coordinator will plan, operationalize, and supervise adult and juvenile detention facilities operational, administrative, clinical, and reporting activities for the Medi-Cal Transformation Justice-Involved Initiative under general supervision and will perform related duties as required. To learn more about the Sheriff's Department, click here .
Click here for details.

Unless otherwise provided, this position is part of the Unclassified Service of the County and considered “at will” for labor relations purposes.
The individual selected will participate in the Stanislaus County Pay-for-Performance program, as well as receive additional benefits.
Incumbents may also be subject to overtime, standby, callback, weekend, holiday and shift assignments as identified in their MOU (Memorandum of Understanding).

Typical Tasks

Ensures compliance with the Medi-Cal Transformation Justice-Involved Initiative requirements as outlined in the most recent version of the DHCS Policy and Operational Guide for Planning and Implementing the Medi-Cal Transformation Justice-Involved Initiative. The position is responsible for overseeing compliance with pre-release activities, including but not limited to:

• Screening for Pre-Release Services
• Screening for Behavioral Health Linkages
• Medi-Cal Billing and Provider Enrollment
• Pre-Release Care Management
• Clinical Consultation
• Medications and Medication Administration
• Medication-Assisted Treatment (MAT)
• Medications and Durable Medical Equipment (DME) Upon Release
• Data Sharing
• Reporting and Oversight
• Collaborate with multidisciplinary staff and stakeholders, including custody, healthcare, social services staff, whose responsibilities contribute to achieving and maintaining Medi-Cal Transformation Justice-Involved Initiative compliance;
• Works collaboratively and on behalf of the Sheriff’s Office and the Probation Department with other public, private, and community organizations on Medi-Cal Transformation Justice-Involved Initiative activities, including Behavioral Health and Social Services, the Sheriff’s Office healthcare provider, Managed Care Plans, and Enhanced Care Management providers;
• Provide guidance to subordinates on department philosophy, goals, objectives, policies, and procedures related to the Medi-Cal Transformation Justice-Involved Initiative;
• Evaluates overall provision of services, including methods and procedures for effectiveness and consistency with program goals and objectives of achieving and maintaining Medi-Cal Transformation Justice-Involved Initiative compliance and offers recommendations for process improvements;
• When appropriate, provides consultation and educational services to clients and public and private agencies in the county pertaining to the Medi-Cal Transformation Justice-Involved Initiative;
• Under the direction of the Adult Detention Captain, interviews, selects, and makes recommendations on the hiring of new staff members whose roles will impact Medi-Cal Transformation Justice-Involved Initiative compliance;
• Ensure Quality Improvement processes are in place to optimize Medi-Cal revenue;
• Collaborate with staff to ensure claims and billing processes are in place for accurate claims submissions to maximize Medi-Cal revenue;
• Optimize care delivery related to Medi-Cal Transformation Justice-Involved Initiative;
• Facilitates ongoing stakeholder engagement to operationalize and optimize the initiative.

Minimum Qualifications (Knowledge, Skills, Abilities, Education/Experience)

SKILLS/ABILITIES

• Plan, organize, and direct assigned multidisciplinary staff;
• Understand, Interpret, explain, and apply applicable Medi-Cal Transformation Justice-Involved Initiative laws, rules, regulations and policies;
• Develop, monitor, and coordinate Medi-Cal Transformation Justice-Involved Initiative program goals and activities;
• Prepare and enforce department procedures relating to Medi-Cal Transformation Justice-Involved Initiative training and organization;
• Establish and maintain cooperative working relationships with staff, subordinates, healthcare provider staff, behavioral health agency staff, pre-release care managers, Enhanced Care Manager providers, contract providers, County and State representatives, consumers and their family members, community groups, and the public;
• Communicate effectively, orally and in writing, in order to present findings and recommendations to individuals and large groups;
• Principles and practices of supervision and management.

KNOWLEDGE

• Provision of healthcare services within a carceral setting;
• Evidenced-based Reentry Services;
• California’s, the Medi-Cal Transformation Justice-Involved Initiative;
• California’s Medi-Cal public insurance system includes managed care and fee-for-service models;
• Unique healthcare and health-related social needs of incarcerated and formerly incarcerated persons;
• Budget planning and public sector financial management;
• Knowledge of laws, legal codes, court procedures, precedents, government regulation, executive orders and agency rules;
• Knowledge of principals and practices for project management and techniques for assessing workflow output;
• Principles of personnel management and supervision; clinical organization and management;
• Experience with complex health care management and transitions of care;
• Experience with Operational Policy implementation and management.

We recognize your time is valuable, please only apply if you meet the following required qualifications. EDUCATION AND EXPERIENCE These employment standards are typically attained with the completion of the following education and experience:

• Possession of a valid license as a Vocational Nurse issued by the California Board of Vocational Nursing AND
• Six (6) years of progressively responsible experience in a health care/behavioral health setting with a minimum of one (1) year of public sector program management; OR
• Possession of a valid license as a Psychiatric Technician issued by the California Board of Vocational Nursing AND
• Six (6) years of progressively responsible experience in a healthcare/behavioral health setting with a minimum of one (1) year of public sector program management; OR
• Possession of a valid license as a Registered Nurse issued by the California Board of Registered Nursing AND
• Three (3) years of progressively responsible experience in a health care/behavioral health setting with a minimum of one (1) year of public sector program management; OR
• Possession of a Masters in Social Work, Healthcare Administration or Marriage and Family Therapy AND
• One (1) year of progressively responsible experience in a health care/behavioral health setting with a minimum of one (1) year of public sector program management.

Proof of education/licenses/certificates are required for verification purposes at the time of application. Applicants who are unable to submit proof must call 209-567-4412 to make other arrangements before 5 pm on the final filing date. Failure to submit proof or make other arrangements before the final filing deadline will result in disqualification. DESIRABLE QUALIFICATIONS
In addition to the minimum qualifications, applicant screening will focus on the following desirable qualifications. Please list any of these qualifications you may have within the "Duties" section of the online application.

• One year of full-time experience in an adult or juvenile detention center

NOTE: No felony convictions. Must be of good moral character and must not have been convicted of a crime for which the punishment could have been imprisonment in a Federal penitentiary or State prison. Proof of education is required for verification purposes at the time of application. Applicants who are unable to submit proof must call (209) 567-4412 to make other arrangements before 5 pm on the final filing date. Failure to submit proof or make other arrangements before the final filing deadline will result in disqualification.

Application and Selection Procedures

APPLICATION PROCEDURES/FINAL FILING DATE Applications cannot be submitted later than 5:00 p.m. on the final filing date. Make your online application as complete as possible so a full and realistic appraisal may be made of your qualifications. Resumes will not be accepted in lieu of a completed application. Attaching your resume and cover letter are an optional feature for those who wish to do so in addition to completing the required application. Information on your resume and cover letter will not substitute for the education, work experience and required fields on the County application. The online County application is the primary tool used to evaluate your job qualifications. EXAMINATION PROCESS Most County recruitments consists of the steps detailed below and are governed by Merit Principles. The examination process ensures that all applicants are given the same opportunity to gain employment within Stanislaus County. ·

• Application Review and Screening. Applications are carefully screened based on information provided. Those who submit incomplete applications that lack relevant qualifications or do not submit all required documents will not be invited to move on.
• Written Examination. Applicants will be invited to participate in a written exam that tests knowledge for the position.
• Oral Examination. Applicants are invited to a panel interview in which they will be evaluated by County subject matter experts. · Eligible Lists. Candidates who pass the examination will be placed on an eligible list for that classification.
• Eligible lists are effective for six months, but may be extended up to eighteen months.

TENTATIVE RECRUITMENT SCHEDULE Application Deadline: February 5, 2025 Oral Examination: Tentatively scheduled for the week of February 17, 2025 Note: The eligible list generated from this recruitment may be used to fill future extra-help, part-time and full-time vacancies throughout Stanislaus County. GENERAL INFORMATION Final appointment will be conditional upon successfully passing a County paid pre-employment drug screening (if applicable for position) and a job-related background investigation. Some positions may require possession or the ability to obtain, and maintenance of a valid California Driver’s license or the ability to utilize an alternative method of transportation when needed to carry out job related essential functions. Stanislaus County supports the good health of its workforce. More information is available at http://myclubwellness.org Cell phones are typically incompatible with the online application format or browser. We recommend using a desktop or laptop computer. If you are still having technical difficulties, please call NEOGOV at 1-855-524-5627.

Benefits associated with this position can be found at Benefits Summary .

Closing Date/Time: 2/6/2025 5:00 PM Pacific

Salary:

$87,131.20 - $130,686.40 Annually