Department of Behavioral Health and Developmental Services
Service Authorization Consultant
Department of Behavioral Health and Developmental Services, Richmond, Virginia, United States, 23214
Overview
The Department of Behavioral Health and Developmental Services (DBHDS) is seeking a Service Authorization Consultant to ensure that the Developmental Disabilities waivers’ service authorization system maintains standards of accountability, proficiency, and responsiveness to users. The incumbent will review Individual Support Plans, Individual Service Packages, Planning Calendars, and Service Authorizations to ensure all criteria are met from initiation with the case manager/support coordinator through to the authorization of services. This includes discussing appropriate service alternatives with support coordinators and case managers, providing needed training and technical assistance, problem solving to ensure individuals receive appropriate services, and communicating the results of the review process to CSBs, private providers, and the VA Medicaid Management Information System. This is a Richmond Central Office position located at 1220 Bank Street, Richmond, VA 23219, with limited telework (one day per week) and regular travel as required.
Title:
Service Authorization Consultant
State Role Title:
Health Care Compliance Spec II
Hiring Range:
Up to $65,000
Pay Band:
5
Agency:
Dept Behavioral Health/Develop
Location:
Central Office
Agency Website:
www.dbhds.virginia.gov
Recruitment Type:
General Public - G
Responsibilities
Perform clinical review and/or authorization of waiver and EPSDT services for individuals with developmental disabilities for all new and revised service plans, as appropriate.
Utilize knowledge of authorization procedures and interpretation of Medicaid regulations, policies, and procedures.
Accurately enter service authorization information into the Waiver Management System (WaMS) and the Virginia Medicaid Enterprise System (MES).
Provide service authorization related consultation and training to assigned Community Services Boards/private providers of case management services.
Analyze trends and problem areas within localities; provide recommendations and assistance to other DBHDS staff regarding technical support, training, and the development of guidance materials.
Abide by all legal and regulatory standards promulgated by state, federal, and professional regulatory organizations and maintain professional, ethical conduct at all times.
Minimum Qualifications
Knowledge of professional standards of supports and services for individuals with developmental disabilities (DD), including knowledge of best practices.
Knowledge of the health care needs of persons with disabilities, health and social service programs and issues, community resources, state and federal DD regulations, negotiation techniques, problem resolution, medical terminology, and medical standards of treatment.
Ability to work with electronic information systems.
Demonstrated ability to organize and prioritize work assignments, and to communicate effectively orally and in writing.
Ability to research and identify changes in program requirements and policies and to interpret state and federal regulations.
Ability to use a range of computer programs and database applications such as Word, Excel, and the Internet.
Additional Considerations
Bachelor’s degree in a human services field (including sociology, social work, special education, rehabilitation counseling, or psychology).
Demonstrated training/professional experience in the delivery of services to individuals with DD.
Experience in social, behavioral science, education, or related human services field.
Understanding of best practices in developmental disability (DD) services or ability to translate experiences and training within the DD system.
Special Instructions You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to Your Application in your account to check the status of your application for this position.
This position is eligible, however not guaranteed, for telework opportunities; availability, hours, and duration of telework shall be approved as outlined in the Commonwealth telework policy.
For consideration, interested applicants must apply by completing the online application. A resume may also be included with your submission. However, emailed, faxed, and hand-delivered applications and/or resumes will not be accepted. This position is open until filled; however, applications/resumes will begin to be reviewed within seven (7) business days of the posting date. Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act.
DBHDS welcomes all applicants authorized to work in the U.S. For more information on how to seek this authorization, please refer to Working in the United States or contact the U.S. Citizenship and Immigration Services office directly.
For any technical assistance with the jobs.virginia.gov website, please contact applicantinquiry@dhrm.virginia.gov.
Contact Information Name: ShaKiera Miles Email: shakiera.miles@dbhds.virginia.gov - Inquiries Only/No Submissions, to include resumes.
Job Details
Seniority level: Entry level
Employment type: Full-time
Job function: Consulting, Information Technology, and Sales
Industries: Health and Human Services
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Title:
Service Authorization Consultant
State Role Title:
Health Care Compliance Spec II
Hiring Range:
Up to $65,000
Pay Band:
5
Agency:
Dept Behavioral Health/Develop
Location:
Central Office
Agency Website:
www.dbhds.virginia.gov
Recruitment Type:
General Public - G
Responsibilities
Perform clinical review and/or authorization of waiver and EPSDT services for individuals with developmental disabilities for all new and revised service plans, as appropriate.
Utilize knowledge of authorization procedures and interpretation of Medicaid regulations, policies, and procedures.
Accurately enter service authorization information into the Waiver Management System (WaMS) and the Virginia Medicaid Enterprise System (MES).
Provide service authorization related consultation and training to assigned Community Services Boards/private providers of case management services.
Analyze trends and problem areas within localities; provide recommendations and assistance to other DBHDS staff regarding technical support, training, and the development of guidance materials.
Abide by all legal and regulatory standards promulgated by state, federal, and professional regulatory organizations and maintain professional, ethical conduct at all times.
Minimum Qualifications
Knowledge of professional standards of supports and services for individuals with developmental disabilities (DD), including knowledge of best practices.
Knowledge of the health care needs of persons with disabilities, health and social service programs and issues, community resources, state and federal DD regulations, negotiation techniques, problem resolution, medical terminology, and medical standards of treatment.
Ability to work with electronic information systems.
Demonstrated ability to organize and prioritize work assignments, and to communicate effectively orally and in writing.
Ability to research and identify changes in program requirements and policies and to interpret state and federal regulations.
Ability to use a range of computer programs and database applications such as Word, Excel, and the Internet.
Additional Considerations
Bachelor’s degree in a human services field (including sociology, social work, special education, rehabilitation counseling, or psychology).
Demonstrated training/professional experience in the delivery of services to individuals with DD.
Experience in social, behavioral science, education, or related human services field.
Understanding of best practices in developmental disability (DD) services or ability to translate experiences and training within the DD system.
Special Instructions You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to Your Application in your account to check the status of your application for this position.
This position is eligible, however not guaranteed, for telework opportunities; availability, hours, and duration of telework shall be approved as outlined in the Commonwealth telework policy.
For consideration, interested applicants must apply by completing the online application. A resume may also be included with your submission. However, emailed, faxed, and hand-delivered applications and/or resumes will not be accepted. This position is open until filled; however, applications/resumes will begin to be reviewed within seven (7) business days of the posting date. Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act.
DBHDS welcomes all applicants authorized to work in the U.S. For more information on how to seek this authorization, please refer to Working in the United States or contact the U.S. Citizenship and Immigration Services office directly.
For any technical assistance with the jobs.virginia.gov website, please contact applicantinquiry@dhrm.virginia.gov.
Contact Information Name: ShaKiera Miles Email: shakiera.miles@dbhds.virginia.gov - Inquiries Only/No Submissions, to include resumes.
Job Details
Seniority level: Entry level
Employment type: Full-time
Job function: Consulting, Information Technology, and Sales
Industries: Health and Human Services
#J-18808-Ljbffr