Board Certified Behavior Analyst

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).
KHS reasonably expects to pay starting compensation for the position of Board Certified Behavior Analyst in the range of $35.50 - $47.48 hourly.
Our Mission.. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.
About the role
Under the direction of the Behavioral Health leadership, this position will be responsible to provide utilization oversight and review of applied behavior analysis services to members diagnosed with Autism Spectrum Disorders (ASD) and other behavioral and mental health conditions.
The BCBA Care Manager works directly with the BH department and staff from other departments, members, external care managers, and providers in assessing and providing appropriate services to achieve positive health outcomes. This position, like all positions within the Behavioral Health Department, is expected to model behavioral health principles of relationship-based care, as well engage in promoting education and understanding of behavioral health and its importance in whole health, to those within KHS and in the community.
Distinguishing Characteristics
This position will work under the direction of the Behavioral Health Director to implement processes to ensure effective delivery of the Behavior Health Therapy (BHT) benefit.
The BCBA Care Manager will achieve quality and productivity standards and ensure compliance with department policies and procedures. The BCBA Care Manager is responsible for the daily operation of Behavioral Health Treatment (BHT) services program, including Applied Behavior Analysis (ABA), under the Early and Periodic Screening Diagnostic and Treatment (EPSDT) program. This includes operational Case and Utilization Management for members who require CDE, BHT and ABA services. This position will ensure that members receive appropriate provider linkage. The position will also oversee and review assessments and provider-submitted treatment plans.
The BCBA Care Manager will collaborate with other internal KHS departments to ensure regulatory compliance. The position will interact with delegates, contracted organizations, providers, health networks, and other stakeholders in a manner that promotes collaborative working relationships.
Principal responsibilities include:

• Oversee the BHT, ABA and CDE services including Care Coordination, Case Management and Utilization Management.
• Identify, develop, and manage programs and processes to identify and manage high risk members to improve member's health outcomes.
• Assist in developing and implementing business requirements for any software systems that will be used in the assessment, care coordination and case management processes.
• Oversee the collection, analysis, and reporting of Care Coordination, BHT, ABA and CDE Referral, Case Management and Utilization Management based on MCG clinical guidelines, state, and federal standards.
• Recommend process and performance improvement for the BHT, ABA and CDE services.
• Engage internal and external stakeholders in care coordination/case management processes, promote interdisciplinary collaboration, foster teamwork, and champion service excellence in keeping with organizational goals.
• Anticipate, identify, and analyze care issues and trends, make appropriate recommendations, develop and implement best practice pilot projects aimed at improving quality healthcare outcomes under the guidance of BH director.
• Prepare for and participate in regulatory audits and develop and monitor corrective actions plans related to BHT, ABA and CDE services.
• Oversee BHT, ABA and CDE workload and ensure that timely and effective adjustments are made to ensure timely service to members.
• Assist with the development of desk level procedures, policies, and necessary care management protocols.
• Maintains clinical expertise and knowledge of best practices for all relevant clinical areas of BHT/ABA and behavioral health including statutory and regulatory requirements.
• Work closely with licensed and unlicensed staff to co-manage the care of complex cases telephonically through regular contact with members, caretakers, healthcare professionals and others involved in the member's care
• In coordination with various departments to support the Plan's efforts to achieve NCQA accreditation and to maintain all statutory and regulatory requirements on key measures pertaining to BHT/ABA and behavioral health including the review of the policies and practices of delegated entities.
• Works to clarify issues regarding a member status, needs, and goals.
• Reviews activities including progress and barriers towards goals, resolves conflicts or strategizes solutions and adjusts current service plans as needed
• Recommends strategies to enhance existing networks performance as identified.
• Develops clinical guidelines, policies, and procedures for the provision of BHT, ABA and CDE services.
• Acts as a liaison to community based and governmental providers that serve members.
• Coordinates and consults with the Plan's contracted subject matter experts: including Licensed neuropsychologists, BCBA's, neurologists, speech therapists or others as directed by the Behavioral Health leadership to facilitate individual treatment plans and utilization management for members receiving BHT, ABA and CDE services.
• Adheres to administration of BHT, ABA and CDE services including identification and development of clinical practice guidelines and associated trainings.
• Confers with internal KHS staff as needed to address patterns of utilization and assure that BHT, ABA and CDE services are maintained at an acceptable level of quality.
• In conjunction with compliance, reviews and analyzes reports and policies provided by delegated vendors and participates in on-site audits as requested.
• Provides guidance to the BH clinical staff and Navigators on issues related to BHT/ ABA services provided to members.
• Collaborates with the other local agencies focused on special needs, mental health and substance use, including Regional Center, County Behavioral Health, and Drug Medi-Cal Organized Delivery System to ensure smooth transitions across the continuum of health care.
• Serves as an BHT, ABA and CDE benefit expert for internal departments, health networks, and contracted providers.
• Perform other duties, projects or functions as assigned.

Essential Duties and Responsibilities

• Serve as subject matter expert in BHT, ABA and CDE programs in support of improving patient experience of care, health outcomes, and reducing overall cost.
• Writing, reporting, administration, and analysis.
• Developing long and short-range strategic plans for BHT, ABA and CDE activities.
• Maintain active unrestrictive registration/license(s) as a BCBA.
• Overseeing daily work of BHT, ABA and CDE Services and leading and participating in internal and external committees and meetings.
• Evaluating data analytics pertaining to BHT, ABA and CDE utilization.
• Communicating effectively and efficiently internally and externally.
• Complying with the organization's Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
• Making oral presentations, as requested.
• Oversee and perform the primary functions within the BHT, ABA and CDE services including:

1. Timely review of outpatient authorization requests within regulatory guidelines
2. Communicate and coordinate with BHT, ABA and CDE providers, specialists and vendors as appropriate to determine medical necessity of a request.
3. Serve as a clinical resource to other clinical staff including BCBAs and non-clinical staff, as needed.
4. Ability to multi-task and prioritize tasks.
5. Work closely and in collaboration with all staff to maintain open communication among all the clinical departments and create a positive team culture.
6. Perform all job functions with integrity and provide timely internal and external customer service in cooperative, professional, and respectful manner.

Supervisory Responsibilities
N/A
Candidate Requirements
Education or Training Equivalent To:

• Board Certified Behavioral Analyst (BCBA) or BCBA-D is required.
• Master's degree in Social Work, Psychology, Marriage and Family Therapy, Education or other related field is preferred.

Experience: Minimum of 5 years of experience providing BHT/ABA therapy to children diagnosed with ASD is required and working with health care delivery systems and/or in a public agency serving the related population preferred.
Knowledge/Skills Requirement

• In depth understanding of BHT, ABA and CDE standards and clinical care best practices.
• Excellent written and verbal communication skills required.
• Experience with Medi-Cal program, Department of HealthCare Services and Department of Managed HealthCare preferred.
• Ability to use and manipulate reported data to assess department metrics.
• Familiarity with HMO and medical group contracting concepts, principles, and practices.
• Experience in use of various computer system software including pharmacy programs, as well as Windows, Word, Excel, Outlook, and PowerPoint.
• Experience managing BHT, ABA and CDE services including the oversite of BCBAs and non-clinical support staff.

Must have: Excellent written, verbal, and interpersonal communication skills required. Applicants should be able to demonstrate knowledge and experience of managed care systems. Have demonstrated skills in coordination and problem solving with members and providers. Shows teamwork and leadership skills including integrity, empathy, positivity, and confidence.
Other Requirements: Possession of valid driver's license and proof of State required auto liability insurance. Required Travel Up to 5%
We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.
Other details

• Pay Type Hourly
• Min Hiring Rate $35.50
• Max Hiring Rate $47.48
• Travel Required Yes
• Travel % 5
• Telecommute % 0
• Required Education Bachelor's Degree

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