About the position

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Behavioral Health Care Manager, SKI (Specialty Kids Intervention) BCBA is responsible for all aspects of services to IEHP members with autism, developmental disabilities, and/or intellectual disabilities and children with severe behavioral needs. The Behavioral Health Care Manager, SKI BCBA will also be responsible for reviewing requests for services, applying clinical criteria, applying clinical expertise to review treatment plans and authorizing services to ensure quality care coordination. This position ensures effective call support, case management as needed, care coordination as needed, and referral support. Under the direction of department leadership, the Behavioral Health Care Manager, SKI BCBA position works collaboratively with members of their own team, IEHP members and families, community agencies, and with the designated health care organization (HCO) medical team. This position is expected to model IEHP principles of relationship-based care, as well engage in promoting education and understanding of behavioral health and its importance in whole health, to those within IEHP and in the community. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

Responsibilities

• Adhere to the ethical guidelines of the BACB Board.
• Provide support to the SKI team to ensure implementation of timely processes, follow-through of calls, task completion, and case management functions.
• Provide guidance in the realm of autism, developmental disabilities, and behavior analytic practices for the SKI team and all departments, when needed.
• Work with BHT providers and other providers (Primary Care, Speech Therapist, etc) within the IEHP network; develop genuine and effective relationships with providers.
• Participate in clinical review meetings for Members regarding behavioral concerns, barriers to treatment or treatment progress, as needed.
• Ensure treatment plans are updated, assessment results are updated, the treatment goals align to the assessment results and that goals meet medically necessary criteria.
• Become proficient in all electronic medical management systems (e.g. Cisco, MedHOK, HSP, Super Search and Web Portal) to assist in training of new staff members.
• Review requests for services, apply clinical criteria, and apply clinical expertise to review treatment plans and authorizing services.
• Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members.
• Participate in other committees as needed, Interdisciplinary Care Conferences, and any other meetings as required or directed by department managers or Directors.
• Work with a caseload of Members with developmental delays as needed.
• In conjunction with department leadership, provide consultation for the non-certified/licensed team members when discussing tasks of a clinical nature.
• Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards.
• Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Requirements

• Three (3) years of experience working in a setting offering services to individuals with autism, developmental or intellectual disabilities required
• Significant experience reviewing Behavioral Health Treatment Plans and Behavior Intervention Plans (BIPs)
• Master’s degree in Social Work/Psychology or related field from an accredited institution with ABA specialization required
• Possession of an active, unrestricted, and unencumbered Board-Certified Behavior Analyst (BCBA) certification issued by the Behavior Analyst Certification Board required
• Deep knowledge and skills in Autism; Applied Behavioral Analysis, Special Education skills in engaging and serving families
• Understanding of and sensitivity to multi-cultural communities
• Deep understanding and knowledge of mental health
• Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
• Must have knowledge of whole health and integrated principles, theories, and practices
• Knowledge of community resources and health plan benefits
• Skillful at telephonic information delivery and counseling support to Members, their caregivers, and their families
• Effective reasoning and problem-solving skills
• Excellent relationship, communication (written and verbal), and interpersonal skills, including conflict resolution
• Must have resiliency to tolerate, adapt, and manage effective use of a high level of ambiguity around new team models, new models of care, and new care management practices
• Proficient in the use of computer software to include but not limited to: (e.g. Microsoft Word and Excel, Power Point) for use in all aspects of an office environment
• Excellent organizational skills while effectively multi-tasking on various projects
• Ability to undertake and write telephonic clinical mental health assessments which meet specified regulatory standards.
• Ability to interview, assess, and coordinate care
• Skilled in researching applicable resources for members
• Proven ability to: Work as a member of a highly autonomous team, executing job duties and making skillful decisions as an independent team member within one's scope
• Show desire and develop genuine, effective relationships with members, co-workers, supervisors, and community/HCO partners at all levels
• Support others to utilize telephonic means to engage, assess and assist members is required
• Provide vision, leadership, and support to a team
• Communicate and work effectively with a variety of providers and maintain positive working relationships with internal and external contacts at all levels
• Show a high degree of patience
• Learn new computer systems
• Prioritize multiple tasks as well as identify and resolve problems
• Have effective time management and the ability to work in a fast-paced environment
• Have timely turnaround of assignments expected
• To form cross-functional and interdepartmental relationships

Nice-to-haves

• Experience in leading a team is preferred
• Experience in an HMO or experience working in psychiatric facility or county hospital facility preferred
• Familiarity with Managed Care and discharge planning is preferred
• Bilingual written and verbal is highly preferred
• Demonstrated proficiency with all electronic medical management systems (e.g., Cisco, MHK/Care Prominence, MediTrac, SuperSearch and Web Portal) is preferred

Benefits

• Competitive salary
• Hybrid schedule
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance