Address
Form of workSalary: $5,479.00 - $7,368.00 Monthly
Location : Multiple Locations Statewide, WA
Job Type: Full Time - Permanent
Remote Employment: Remote Only
Job Number: 2024-02021
Department: Dept of Children, Youth, and Families
Opening Date: 03/06/2024
Closing Date: 3/21/2024 11:59 PM Pacific
Salary Information: The high end of the salary range, Step M is typically a longevity step
Description
Job Title:Statement of Medical Necessity Specialist (PS5)
Location: Olympia, WA - Remote Only - Aside from a few in-office meetings a year, this position is 100% telework.
Closes: Thursday, March 21, 2024
Salary: $ 5,479 - $ 7,368 Monthly
Our Division of Partnership, Prevention and Services at HQ in the Integrated Health Services Unit is looking for a Statement of Medical Necessity Specialist (Program Specialist 5) to join our team as a subject matter expert responsible for determining Medical Necessity for children and youth referred to, or receiving, services from Behavior Rehabilitation Services (BRS) contracted by DCYF. This will ensure proper qualification for services, and for DCYF to draw down federal Title 19 funds. Apply today.
Contact the hiring manager, Angela Pelfrey, at for more information.
to learn more about DCYF.
The Opportunity:
As a Statement of Medical Necessity Specialist, you will work statewide with field staff and coordinate with the headquarters Continuum of Behavioral Health and Placement Continuum units. You will gather information on referred children and youth, review files, mental health criteria, BRS referrals, and FamLink. This position partners with the Health Care Authority (HCA), mental health providers, and Coordinated Care of WA Apple Health Core Connections (AHCC) to make a timely Medical Necessity determination. Additionally, this position has a quality assurance role that not only monitors compliance with state and federal regulations but ensures that children and youth with complex behavioral health needs receive this intensive BRS-level of care.
Some of what you'll do:
| Required Qualifications:
Understanding of Medical Necessity Criteria and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Note(s):
One (1) year of post licensure may be waived for one (1) year of working in children's mental health, and social work with supervision while obtaining licensure.
Degree must be obtained from an accredited college or university whose accreditation is recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA), or foreign equivalent verified by a NACES-approved organization at naces.org.
*Foreign Equivalency certification must be attached to the application for degrees obtained outside the U.S. Incomplete applications may be screened out of the recruitment process.*
|In addition to those required qualifications, our ideal applicant will also have some or all of the following:
How do I apply?In addition to completing the online application, applicants must attach the following documents to their profile in order to be considered for this position:
Supplemental Information:
The Department of Children, Youth, and Families (DCYF) is committed to Washington's children and youth growing up safe, healthy, and thriving. We invite all candidates to join us in our mission to create a diverse and equitable workplace that reflects the communities we serve. If you are excited about this role but you believe that your education and/or experience might not align perfectly with every qualification in the job posting, we encourage you to apply anyway.
The Department of Children, Youth, and Families (DCYF) is an equal opportunity employer and does not discriminate on the basis of age, sex, marital status, sexual orientation, race, creed, color, national origin, honorably discharged veteran or military status, or the presence of any sensory, mental, or physical disability or the use of a trained service animal by a person with a disability.
Prior to a new hire, a background check including criminal history will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the position.
If you have any questions pertaining to this recruitment or if you would like to request an accommodation throughout the application/interview process, contact Ant'juan D.R. (Talent Acquisition Specialist) at antjuan.ratliff@dcyf.wa.gov. If you're experiencing technical difficulties creating, accessing, or completing your application, call NEOGOV toll-free at (855) 524-5627, or email .
Persons needing accommodation in the application process or this announcement in an alternative format may call (360) 902-2276 or the Telecommunications Device for the Deaf (TDD) at (800) 833-6388.
2024 - 02021
More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.
We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.
Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.
Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.
Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.
Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.
Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
The Washington State Employee Assistance Program promotes the health and well-being of employees.
Retirement and Deferred Compensation
State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.
Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.
Social Security
All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.
Public Service Loan Forgiveness
If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.
Holidays
Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.
Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.
Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.
Sick Leave
Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.
Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.
Vacation (Annual Leave)
Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.
Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.
Pay status includes hours worked, time on paid leave and paid holiday.
As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.
Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.
Military Leave
Washington State supports members of the armed forces with 21 days paid military leave per year.
Bereavement Leave
Most employees whose family member or household member dies, are entitled to three (3) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.
Additional Leave
Leave Sharing
Family and Medical Leave Act (FMLA)
Leave Without Pay
Please visit the State HR Website for more detailed information regarding benefits.
Updated 12-31-2022
01
Are you a current and active employee with the Department of Children, Youth & Families (DCYF)?
02
Please select the answer that best describes your education as it relates to this position.Please ensure that your application accurately reflects...
Location : Multiple Locations Statewide, WA
Job Type: Full Time - Permanent
Remote Employment: Remote Only
Job Number: 2024-02021
Department: Dept of Children, Youth, and Families
Opening Date: 03/06/2024
Closing Date: 3/21/2024 11:59 PM Pacific
Salary Information: The high end of the salary range, Step M is typically a longevity step
Description
Job Title:Statement of Medical Necessity Specialist (PS5)
Location: Olympia, WA - Remote Only - Aside from a few in-office meetings a year, this position is 100% telework.
Closes: Thursday, March 21, 2024
Salary: $ 5,479 - $ 7,368 Monthly
Our Division of Partnership, Prevention and Services at HQ in the Integrated Health Services Unit is looking for a Statement of Medical Necessity Specialist (Program Specialist 5) to join our team as a subject matter expert responsible for determining Medical Necessity for children and youth referred to, or receiving, services from Behavior Rehabilitation Services (BRS) contracted by DCYF. This will ensure proper qualification for services, and for DCYF to draw down federal Title 19 funds. Apply today.
Contact the hiring manager, Angela Pelfrey, at for more information.
to learn more about DCYF.
The Opportunity:
As a Statement of Medical Necessity Specialist, you will work statewide with field staff and coordinate with the headquarters Continuum of Behavioral Health and Placement Continuum units. You will gather information on referred children and youth, review files, mental health criteria, BRS referrals, and FamLink. This position partners with the Health Care Authority (HCA), mental health providers, and Coordinated Care of WA Apple Health Core Connections (AHCC) to make a timely Medical Necessity determination. Additionally, this position has a quality assurance role that not only monitors compliance with state and federal regulations but ensures that children and youth with complex behavioral health needs receive this intensive BRS-level of care.
Some of what you'll do:
- Gather and review information in FamLink, among other certified sources, to establish a Statement of Medical Necessity and/or continuation of Medical Necessity.
- Assess available information to determine Medical Necessity of children or youth receiving BRS services.
- Make determinations to draft clear and comprehensive reports.
- Collaborate with internal and external partners to inform program development and improvements related to the referral and review process.
- Track and analyze outcomes and performance data.
- Develop and submit quarterly reports.
| Required Qualifications:
- A Master's Degree in Mental Health Counseling, Social Work, Psychology, and/or healing arts.
- Two (2) years of post-graduate experience in completing clinical Mental Health assessments and determining Medical Necessity, of children and youth with Serious Emotional Disturbance (SED) in a hospital, residential, and/or community-based mental health setting.
- Current/Active Licensure in WA State in one or more of the following:
- Mental Health (including LICSW, LMHC, and LMFT)
- Psychological (PsyD, PhD)
- Advanced Registered Nurse Practitioner (ARNP)
- Doctor of Medicine (MD)
Note(s):
One (1) year of post licensure may be waived for one (1) year of working in children's mental health, and social work with supervision while obtaining licensure.
Degree must be obtained from an accredited college or university whose accreditation is recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA), or foreign equivalent verified by a NACES-approved organization at naces.org.
*Foreign Equivalency certification must be attached to the application for degrees obtained outside the U.S. Incomplete applications may be screened out of the recruitment process.*
|In addition to those required qualifications, our ideal applicant will also have some or all of the following:
- Demonstrated knowledge of social service principles and practices, goals and objectives of case planning and risk assessment.
- Demonstrated knowledge of protecting vulnerable adults and children living in their own homes, and in licensed, certified settings.
- Demonstrated knowledge of Behavior Rehabilitation Services and/or Intensive Services programming and service delivery.
- Demonstrated knowledge of the Family First Prevention Services Act (FFPSA) requirements as it relates to Qualified Residential Treatment Programs (QRTP).
- Demonstrated and relentless commitment to anti-racism and addressing diversity, disproportionality, and inequity.
- Demonstrated knowledge of the complex mental health needs of children and youth in the foster care system.
How do I apply?In addition to completing the online application, applicants must attach the following documents to their profile in order to be considered for this position:
- Current resume detailing experience and education.
- Cover Letter
- Transcripts
Supplemental Information:
The Department of Children, Youth, and Families (DCYF) is committed to Washington's children and youth growing up safe, healthy, and thriving. We invite all candidates to join us in our mission to create a diverse and equitable workplace that reflects the communities we serve. If you are excited about this role but you believe that your education and/or experience might not align perfectly with every qualification in the job posting, we encourage you to apply anyway.
The Department of Children, Youth, and Families (DCYF) is an equal opportunity employer and does not discriminate on the basis of age, sex, marital status, sexual orientation, race, creed, color, national origin, honorably discharged veteran or military status, or the presence of any sensory, mental, or physical disability or the use of a trained service animal by a person with a disability.
Prior to a new hire, a background check including criminal history will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the position.
If you have any questions pertaining to this recruitment or if you would like to request an accommodation throughout the application/interview process, contact Ant'juan D.R. (Talent Acquisition Specialist) at antjuan.ratliff@dcyf.wa.gov. If you're experiencing technical difficulties creating, accessing, or completing your application, call NEOGOV toll-free at (855) 524-5627, or email .
Persons needing accommodation in the application process or this announcement in an alternative format may call (360) 902-2276 or the Telecommunications Device for the Deaf (TDD) at (800) 833-6388.
2024 - 02021
More than Just a Paycheck!
Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.
We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.
Read about our benefits:
The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.
Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.
Insurance Benefits
Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.
Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.
Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
The Washington State Employee Assistance Program promotes the health and well-being of employees.
Retirement and Deferred Compensation
State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.
Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.
Social Security
All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.
Public Service Loan Forgiveness
If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.
Holidays
Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.
Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.
Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.
Sick Leave
Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.
Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.
Vacation (Annual Leave)
Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.
Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.
Pay status includes hours worked, time on paid leave and paid holiday.
As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.
Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.
Military Leave
Washington State supports members of the armed forces with 21 days paid military leave per year.
Bereavement Leave
Most employees whose family member or household member dies, are entitled to three (3) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.
Additional Leave
Leave Sharing
Family and Medical Leave Act (FMLA)
Leave Without Pay
Please visit the State HR Website for more detailed information regarding benefits.
Updated 12-31-2022
01
Are you a current and active employee with the Department of Children, Youth & Families (DCYF)?
- Yes
- No
02
Please select the answer that best describes your education as it relates to this position.Please ensure that your application accurately reflects...
