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Managed Care Systems Administrator (#MDDZ44)
$62,776.00 Yearly Min / $78,470.00 Yearly Mid / $94,164.00 Yearly Max




Summary Statement

The class incumbent is responsible for planning, developing and implementing, and the service delivery system for the child mental health managed care system.

  • Supervises a staff of 2-5 professional and paraprofessionals.

Nature and Scope

The class incumbent reports to the Division Director and is responsible for managing the development and implementation of a child mental health, alcohol and other drug services managed care program. Incumbent serves as liaison between the division and managed care/cost recovery consultants for implementation of the managed care system. Work includes administrative and fiscal program design of the managed care system, budget development, analysis of existing system and overall program planning and system development. Incumbent works with Medicaid Office to negotiate waivers/contracts; sets policies/procedures to guide system development and capitation proposal, and ensures that cost recovery efforts mesh with managed care planning. In addition, the incumbent develops and coordinates the implementation of a marketing plan for the managed care system and coordinates efforts aimed at public/private integration of the system.

 

Essential Functions

Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.

  • Plans, develops, implements and coordinates the service delivery system for the child mental health managed care system.
     
  • Manages interface between the Division and managed care/cost recovery consultants and other offices.
     
  • Coordinates the planning and development of budget proposals to support the ongoing development and enhancement of the managed care system.
     
  • Maintains schedule for assessing new services or service levels which should be provided; reviews options for maximizing cost recovery on services provided; gathers and analyzes data through audits and interviews to monitor the quality and appropriateness of services.
     
  • Negotiates waivers/contracts with the Medicaid Office.
     
  • Sets policies and procedures to guide system development.
     
  • Analyzes current referral, intake and admission procedures and recommends improvements/modifications to maximize eligibility/recovery.
     
  • Reviews budget and ratesetting methodologies for mental health and drug/alcohol programs and recommends improvements/modifications to maximize recovery/reinvestment.
     
  • Plans, assigns, reviews and evaluates the work of assigned staff.
     
  • Prepares a variety of reports.

Knowledge, Skills and Abilities

The intent of the listed knowledge, skills and abilities is to give a general indication of the core requirements for all positions in the class series; therefore, the KSA’s listed are not exhaustive or necessarily inclusive of the requirements of every position in the class.

  • Knowledge of the principles and practices of management and administration.
  • Knowledge of mental health and drug/alcohol treatment programs, policies and procedures.
  • Knowledge of State and Federal statutes and JCAHO accreditation standards.
  • Knowledge of the methods and techniques of contract negotiation and development.
  • Skill in organizing, directing and coordinating projects.
  • Ability to communicate effectively both orally and in writing.

Job Requirements

JOB REQUIREMENTS for Managed Care Systems Administrator 
Applicants must have education, training and/or experience demonstrating competence in each of the following areas:

  1. Possession of a Bachelors degree or higher in Behavioral or Social Science or related field.
  2. Six months experience in health or human services program administration such as overseeing and directing the development, implementation and evaluation of health or human services programs and services; planning and establishing short and long range program goals and objectives. Providing advice to other agency organizational units through consultation.
  3. Six months experience in budget development which includes analyzing financial data and making long and short range plans and projections.
  4. Six months experience in contract development which includes writing and negotiating contracts.
  5. Six months experience in developing policies and procedures.
  6. Six months experience in staff supervision of two or more employees which includes to plan, assign, review, discipline, recommend hire, promotion, termination and administer performance plans and reviews.

    CLASS:
    MDDZ44
    EST:
    5/1/1994
    REV:
    1/1/1900
    FORMERLY JOB CLASS:
    72104