Jobs search

HEALTH PROGRAM ANALYST III / HEALTH PLAN ACCOUNT MANAGER

County of Los Angeles • Remote (CA, United States) • $200k - $250k / year • 3w ago

HEALTH PROGRAM ANALYST III/HEALTH PLAN ACCOUNT MANAGER

EXAM NUMBER

b4731J

TYPE OF RECRUITMENT

OPEN COMPETITIVE JOB OPPORTUNITY

FILING START DATES

JUNE 5, 2024 AT 8:00 A.M.

This examination will remain open until the needs of the service are met and is subject to closure without prior notice

DEFINITION:

Supervises a team of analysts and other technical and support personnel providing technical and consultative services to the management of a program; or oversees a small Countywide health program.

CLASSIFICATION STANDARDS:
This is the senior-/supervisory-level class in the Health Program Analyst Series. Positions allocable to this class are located in the department of Mental Health and Public Health and typically report to and receive general direction from a program administrator/manager or higher. Positions are distinguished either by responsibility for supervising a team of analysts and other technical and support personnel in the development, implementation, administration, and evaluation of a large program, or by non-supervisory responsibility for these activities for a small program. Factors affecting allocation of positions in the Health Program Analyst Series include but are not limited to scope and complexity of program/clinic, program budget, number and size of contracts, and size and composition of clinical, professional, and support staff.

Manages and maintains a complete understanding of the Managed Care Plans (MCP) assigned to them. Monitors, analyzes, and reports on key metrics using outcome tools to recommend business process or system changes to the HealthPlan MOU Manager. Identifies new problems and creates new solutions to the fast-paced changes in MCP and the Mental Health Plan (MHP). Manages and develops strong partnerships between the MCPs, MHP, contractors, and network Providers.
Supervises staff in order to and maintains ongoing account relationships at various levels with the providers and DMH to resolve complex issues and to effectively deliver accurate, timely, and appropriate information to their assigned health plan accounts. Monitors timely receipt of contractually required reporting. Establishes and maintains MCPs’ contractor providers with key metrics, schedule site visits, Provider manual maintenance log, claims projects, and disputes.
Serves as a communication link between health plan provider accounts and DMH. Completes regularly scheduled meetings with health plan providers, DMH leadership, and external and internal stakeholders and will exchange information and ideas, requests, and other inquiries into actionable items for improved contracting/ relationship management and enhanced operational service delivery.
Provides administrative supervision to subordinate staff; such as, approval of time, performance management, regular supervision meetings, issue escalation and resolution and provides technical guidance with MCP.
Researches and resolves contractual interpretation, operational and/or payment issues; researches and resolves incoming escalated health plan provider inquiries within specified guidelines; educates health plan providers on new protocols, policies, and procedures.

SPECIALTY REQUIREMENTS:

Option I: A Bachelor's Degree from an accredited* college or university in Social Work, Counseling, Health Care Administration/Management, Public Administration, Behavioral Sciences, Social Sciences, Business Administration, or a closely related field. -AND- five years of experience in the analysis of mental health or public health programs**, two years of which must have been at the level of Health Program Analyst II*** performing client service/account management**** experience in a large (500 or more employees) healthcare or health insurance organization such as managed care or commercial health plans.

A Master's Degree from an accredited college or university in Social Work, Counseling, Health Care Administration/Management, Public Administration, Behavioral Sciences, Social Sciences, Business Administration, or a closely related fieldmay be substituted for one year of the required experience in the analysis of mental health or public health programs.

Option II: Seven years of experience performing assignments in mental health or public health program analysis,** two years of which must have been client service/account management**** experience at the level of Health Program Analyst II*** in a large (500 or more employees) healthcare or health insurance organization such as managed care or commercial health plans.

LICENSE: A valid California Class C Driver License or the ability to utilize and alternative method of transportation when needed to carry out job-related essential functions.

PHYSICAL CLASS:

Light. This class includes administrative and clerical positions requiring light physical effort that may include occasional light lifting to a 10 pound limit and some bending, stooping, or squatting. Considerable ambulation may be involved.

SPECIAL REQUIREMENTS INFORMATION:
Applicants must have the required experience at time of filing. Out-of-class experience will not be accepted.

*ACCREDITATION: Accredited institutions are those listed in the publications of regional, national or international accrediting agencies which are accepted by the Department of Human Resources. Publications such as American Universities and Colleges and International Handbook of Universities are acceptable references. Also acceptable, if appropriate, are degrees that have been evaluated and deemed to be equivalent to degrees from United States accredited institutions by an academic credential evaluation agency recognized by The National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators, Inc. (AICE).

Transcript: *In order to receive credit for any college or university course, or any type of college or university degree, such as Bachelor's or higher, you must include a legible copy of the official diploma or official transcripts from the accredited institution which shows the area of specialization with your application at the time of filing or within 7 calendar days of filing.

Official Transcript is defined as a transcript that bears the college seal and states "official and/or copy" issued by the school's Registrar Office. of the transcript from the school's website is NOT considered official and; therefore, will NOT be accepted and may result in your application being incomplete or rejected.

**Analysis of mental health or public health program is defined as the study and investigation of issues and problems of mental health or public health program development, implementation, administration, and evaluation and the generation of applicable solutions and recommendations.

***A Health Program Analyst II in the service of Los Angeles County is defined as responsible for the solution of complex and difficult problems and the making of recommendations in areas of resources and personnel utilization, development, implementation and improvement of programs, and the refinement of practices and policies having a significant impact on the entire program. Health Program Analyst I is distinguished from Health Program Analyst II in that the latter carries out complex and difficult assignments in support of program operations of a medium- to large-sized clinic or a comparably-sized Countywide program; or performs assignments of this nature as part of a centralized, departmental program support function.

****Client service/Account Management is defined as establishing strategic partnerships with executive-level leadership across external health plan entities, hospitals, clinics, and insurance organizations. It involves serving as the executive liaison among a group of stakeholders including the State, health plans, and providers to ensure alignment with the patient’s needs and access to care across health systems, compliance with Medi-Cal and Medicare rules and coverage, and oversight over the contracts with each health plan. Moreover, it requires a profound understanding of health plans, elective benefits, and beneficiary coverage, underscoring its crucial role in ensuring seamless operations and client satisfaction within the business landscape.

DESIRABLE QUALIFICATIONS: Additional credit will be given to qualified applicants who possess the following desirable qualifications.

Experience with the implementation of contracts and monitoring compliance with contractual obligations.

EXAMINATION CONTENT

This examination will consist of an evaluation of training and experience based upon the application, supplemental questionnaire, desirable qualifications at the time of filing, weighted 100%. Additional credit will be given for experience beyond the selection requirements.

CANDIDATES MUST ACHIEVE A PASSING SCORE OF 70% OR HIGHER IN ORDER TO BE PLACED ON THE ELIGIBLE REGISTER.

ELIGIBILITY INFORMATION

Applications will be processed on an "as-received" basis and those receiving a passing score will be promulgated to the eligible register accordingly. The names of candidates receiving a passing grade in the examination will be placed on the eligible register in the order of their score group for a period of twelve (12) months following the date of promulgation. No person may compete in this examination more than once every twelve (12) months.

AVAILABLE SHIFT

Appointees may be required to work any shift, including evenings, nights, weekends and holidays.

SPECIAL INFORMATION

Past and present mental health clients, parents, and family members are encouraged to apply.

FAIR CHANCE EMPLOYER

The County of Los Angeles is a Fair Chance employer. Except for a very limited number of positions, you will not be asked to provide information about a conviction history unless you receive a contingent offer of employment. The County will make an individualized assessment of whether your conviction history has a direct or adverse relationship with the specific duties of the job, and consider potential mitigating factors, including, but not limited to, evidence and extent of rehabilitation, recency of the offense(s), and age at the time of the offense(s). If asked to provide information about a conviction history, any convictions or court records which are exempted by a valid court order do not have to be disclosed.

VACANCY INFORMATION

The eligible register for this examination will be used to fill vacancies in the Department of Mental Health.

APPLICATION AND FILING INFORMATION

Applicants are required to complete and submit an online Los Angeles County Employment Application AND Supplemental Questionnaire in order to be considered for this examination. Paper applications, resumes, or any unsolicited documents will not be accepted in lieu of completing the online application and Supplemental Questionnaire. We must receive your application before 5:00 pm, PT, on the last day of filing. Application filing may be suspended at any time without advance notice.

INSTRUCTIONS FOR FILING ONLINE

Apply online by clicking on the "Apply" tab for this posting. You can also track the status of your application using this website.

Applicants must complete and submit their online applications and upload documents (e.g., Diploma, Resume, etc.) as attachment(s) during application submission or send by email to exams@dmh.lacounty.gov within 7 calendar days from date of application submission. Indicate Health Program Analyst III, on the subject line when sending required documents by email.

The acceptance of your application will depend on whether you have clearly shown that you meet the Selection Requirements. Your online application must show complete license, education and work experience information necessary to evaluate your qualifications. License information section must show title of license, license number, original date of issue, and expiration date. Education information section must include name and address of school attended, complete dates attended, name of course/s taken, number of units earned, and degree/s earned. Work experience section must include job title, employer name and address, name of work area/facility, actual payroll title held and not the working and/or functional titles, from/to dates of employment including month, day and year, total number of months, total number of hours worked per week - not a range of hours (full or part-time), and complete and detailed description of related job duties. If range of hours is provided, experience will be prorated based on the lowest number of hours worked per week. LIST separately each job experience to be evaluated. All information supplied by applicants is subject to verification. We may reject your application at any time during the examination or selection process.

Plan to submit your online application well in advance before the deadline as you may be required to verify your email address. This only needs to be done once per email address, and if you already have a job seeker account on govermmentjobs.com/careers/lacounty,gov you can verify at any time by logging in and following the prompts. This is to enhance the security of your online application and to ensure you do not enter an incorrect email address.

Many important notifications will be sent electronically to the email address provided on the application. It is important that you provide a valid email address. Please add exams@dmh.lacounty.gov as well as noreply@governmentjobs.com and info@governmentjobs.com to your email address and list of approved senders to prevent email notifications from being filtered as spam/junk/clutter mail.

Applicants have the ability to opt out of emails from LA County. If you unsubscribe, you will not receive any email notification for any examination for which you apply with Los Angeles County. Regardless of whether you choose to unsubscribe, you can always check for notifications by logging into governmentjobs.com and viewing your profile in box, which saves a copy of all emailed notices.

IMPORTANT NOTES

• Please note that ALL information included in the application materials is subject to VERIFICATION at any point during the examination and hiring process, including after an appointment has been made.

• FALSIFICATION of any information may result in DISQUALIFICATION or RESCISSION OF APPOINTMENT.

• Utilizing VERBIAGE from Class Specification and/or Selection Requirements serving as your description of duties WILL NOT be sufficient to meet the requirements. Doing so may result in an INCOMPLETE APPLICATION and you may be DISQUALIFIED.

SOCIAL SECURITY NUMBER LANGUAGE

Please include your Social Security Number for record control purposes. Federal law requires that all employed persons have a Social Security Number.

COMPUTER AND INTERNET ACCESS AT LIBRARIES

For candidates who may not have regular access to a computer or the internet, applications can be completed on computers at public libraries throughout Los Angeles County.

NO SHARING USER ID AND PASSWORD

All applicants must file their applications online using their own user ID and password. Using a family member's or friend's user ID and password may erase a candidate's original application record.

DEPARTMENT CONTACT
Department Contact Name: Celia Yeung, Exam Analyst
Department Contact Phone: 323-705-4249 or 213-972-7034
Department Contact Email: exams@dmh.lacounty.gov

ADA Coordinator Phone: 213-972-7034
Teletype Phone: 800-899-4099
California Relay Services Phone: 800-735-2922

#J-18808-Ljbffr