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SalaryCLASSIFICATION TITLE:
Network Operations CoordinatorSALARY:
$68,348.95 - $88,403.65DEPARTMENT:
Community Mental HealthOpening Date:
01/25/2024Closing Date:
02/08/2024 12:00 a.m.FLSA STATUS: Non-exempt - Overtime pursuant to Human Resources and Labor Relations Policy
EMPLOYMENT RELATIONSHIP: Just cause subject to probationary period
GENERAL SUMMARY:
Under direction, assists in the operational oversight and management of Macomb County Community Mental Health (MCCMH) Provider Network Management department to include provider procurement, provider education, provider evaluation, contract negotiations, monitoring of ongoing service provision, compliance with contract provisions and contract management for assigned paneled providers.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
Assists in the implementation of the overall Quality Plan for MCCMH.
Assists in service provider proposal review and negotiations with new contract service agencies.
Assists in the coordination of written contract service agreements and monitoring the provider’s adherence to contractual obligations.
Maintains an ongoing and professional relationship with contract service providers, which includes quarterly contract reviews with the assigned contract agencies.
Provides technical assistance to assigned contract providers (authorization process, development of clean claims, provision of services, coordination within MCCMH to obtain answers to inquiries).
Assists in monitoring compliance of the contract agency with current Federal, State and County policies and/or regulations (CARF, Corporate Compliance, MCO Policies) and works with providers to ensure compliance.
Functions as a liaison between MCCMH and the provider to facilitate the negotiation of provider contracts.
Provides recommended boiler plate language and corresponding attachments in reference to scope of services, anticipated outcomes and performance standards, claims submission instructions, negotiated reimbursement rates, as well as Recipient Rights reporting and requirements.
Ensures provider compliance with training and orientation to MCCMH, which includes contract requirements and related policies and procedures.
Provides administrative assistance and monitoring of the provider network, including participation on selected committees of MCCMH.
Assist in the collection of data for contract compliance activities, including record reviews, contact with network providers, and collaboration within MCCMH administration.
Performs related duties as assigned.
QUALIFICATIONS:
Required Education and Experience
- Bachelor’s Degree in Business Management, Public Administration or other related organizational management degrees from an accredited college or university
- Two (2) or more years of experience in behavioral health or healthcare
Preferred Education and Experience
- Master’s Degree in Health or Human Services, Hospital or Public Administration from an accredited college or university
- Two (2) or more years of experience in contract management, program management or public administration within health services including some experience with hospital inpatient services
Required Licenses or Certifications
- Possession of a valid Michigan driver’s license and operable, insured automobile for authorized travel
COMPETENCIES FOR SUCCESSFUL PERFORMANCE OF JOB DUTIES:
Knowledge of:
- Knowledge of applicable computer applications
- Michigan Mental Health Code
- MCCMH policies, rules, regulations, codes and procedures
- Medicaid Provider Manual
- Modern office procedures, methods and computer equipment
Skill in:
- Using good professional judgment and following complex directions
- Interpersonal skills necessary to develop and maintain effective and appropriate working relationships
- Performing a variety of duties, often changing from one task to another of a different nature
- Providing excellent and timely customer service
- Managing timelines and project deadlines
Ability to:
- Collaborative: Approaches all situations with a teamwork and solution focused mindset demonstrated through active participation in meetings, volunteering to assist teammates and other departments as appropriate. Examples include participation in internal and external committees, subcommittees, process improvement groups or other multi-organizational initiatives
- Accountable: Takes ownership and empowers others to do the same as evidenced by identifying solutions and acting on job responsibilities and organizational objectives, daily
- Respectful: Treats people with dignity while honoring individual differences demonstrated through use of positive and encouraging statements and/or interactions to, about and/or with colleagues and persons served; evidenced by supervisor observation, feedback from other department staff and leadership.
- Work in an environment which embraces the county’s Dignity Campaign
- Effectively speak, write, and understand the English
- Effectively speak, write, and understand a language other than English is preferred
- Understand and carry out oral and/or written instructions
- Accurately organize and maintain paper documents and electronic files
- Maintain the confidentiality of information
- Work independently
WORK ENVIRONMENT/CONDITIONS:
The work environment and exposures described here are representative of those an employee encounters while performing the essential functions of this job.
N/S=Never/Seldom O=Occasionally F/C= Frequently/Continuously
Work Environment
Office or similar indoor environment: F/C
Outdoor environment: N/S
Street environment (near moving traffic): N/S
Construction site: N/S
Confined space: N/S
Exposures
Individuals who are hostile or irate: O
Individuals with known violent backgrounds: O
Extreme cold (below 32 degrees): N/S
Extreme heat (above 100 degrees): N/S
Communicable diseases: N/S
Moving mechanical parts: N/S
Fumes or airborne particles: N/S
Toxic or caustic chemicals, substances, or waste: N/S
Loud noises (85+ decibels): N/S
Blood Borne Pathogens: N/S
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
N/S=Never/Seldom O=Occasionally F/C= Frequently/Continuously
Demand:
Balancing on even or uneven surfaces/ground: N/S
Bending (forward or backward bending at the waist): N/S
Climbing up or down stairs, ladders, scaffolding and platforms: N/S
Crawling (moving about on hands and knees). Inspecting in confined spaces: N/S
Digging: N/S
Driving on sealed and unsealed roads: O
Grasping, gripping, holding, clasping with fingers or hands: O
Kneeling to work at low levels: N/S
Manual Dexterity (fine finger movements i.e., keyboard operating, writing): F/C
Lift/Carry/Move objects from one level/position to another (covered by the items below):
Up to 10 pounds: O
Push/Pull objects away from or towards the body: O
Reaching overhead (arms raised above the shoulder) or forward reaching (arms extended): O
Sitting in a seated position during the task performance: F/C
Standing in an upright position without movement: F/C
Walking considerable distances in the facility on multiple surfaces: F/C
Running considerable distances in the facility on multiple surfaces: O
GENERAL REQUIREMENTS AND DISCLAIMERS:
Complies with P.A. 390, as amended, known as the State’s Emergency Management Act and the County’s Emergency Management resolution as well as all related plans, policies and procedures covered by those statutes.
The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by employees in this job. Employees may be requested to perform job-related tasks other than those specifically presented in this description.
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment amongst other possible accommodations.
GRANT OR EXTERNALLY FUNDED POSITION –This position will continue only if sufficient grant or external funds are provided.
About Us
Macomb County is Michigan’s third most populated county, boasting a population of more than 865,000 residents and growing. From the densely-populated southern cities to the rural northern villages, Macomb County possesses a wealth of assets that make it a desirable place to live, work and play! As the county gains in population and cultural diversity increases, initiatives such as the dignity campaign enables us to cultivate a community that embraces all people and celebrates their unique contributions. Through collaborative community-based activities, Macomb County is promoting multiculturalism and inclusiveness.
