County of Berks, PA · 2 days ago
Health Choices Program Director
633 Court Street, Reading, PA, 19601, US
Full-time
Onsite
Lead/Staff, Director/Executive
5+ years expThe County of Berks, PA is seeking a Health Choices Program Director to oversee the administration of the HealthChoices Program for Berks County. This role includes managing daily operations, liaising with the Department of Human Services, and ensuring compliance with contract requirements.
Responsibilities
Administer the daily operations of the HealthChoices Program, ensuring that requirements under contract with the Department of Human Services (DHS) are met
Serve a key role in the DHS rate-setting process
Serve as the liaison to DHS regarding any HealthChoices administrative matters, including review of the HealthChoices Agreement and rate setting, along with draft regulations and other documents issued by DHS
Monitor the MCO’s performance in relation to contract requirements
Collaborate with MCO on budget development, including review and approval of timely filing requests and monitoring of such
Oversight of MCO’s utilization, network, quality, and risk management
Oversight of project development on initiatives such as Value-Based Purchasing, Regional Accountable Health Council, among others
Review and approve any provider enrollment/expansion as well as provider rate increases
Analyze utilization data to identify system gaps and collaborate with the MCO on service development to fill any existing gaps
Review and approve MCO policies/procedures
Develop and oversee the implementation of reinvestment plans
Establish and monitor contracts with vendors from actuarial, auditing, data analysis, and legal disciplines
Act as a liaison and resource on HealthChoices for County departments, behavioral health providers, community service agencies, and members
Train and supervise HealthChoices staff
Complete mandatory trainings and clearances as required
Complete Emergency Behavioral Health certification
Attend and participate in MH/DD staff and provider meetings as well as website administration/updates
Qualification
Required
Master's degree in social or human services
Five years of progressive behavioral health administrative experience, including budget development and program oversight
Any equivalent combination of experience and training that provides the required knowledge, skills, and abilities
Valid Pennsylvania driver's license with a good driving record
Knowledge of project and quality management, including data collection and analysis
Knowledge of utilization and risk management
Knowledge of the healthcare and insurance industries
Knowledge of budget development
Ability to establish and maintain positive working relationships
Ability to use diplomacy in interactions with other professionals and members
Ability to work independently with minimal supervision
Ability to organize and properly manage time and workload
Ability to communicate effectively both orally and in writing
Skill in operating a variety of computer software programs
Ability to handle stress
Physical presence in the office is required
Company
County of Berks, PA
It is the mission of Berks County government and all County employees to administer and deliver services to the citizens of the County in the most effective, efficient and professional manner possible within the constraints of the financial resources available.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Timothy Smith
Chief Information Officer
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