HealthChoices Project Manager

County of Berks•Reading, PA

2d•Onsite

About The Position

The Project Manager is responsible for the development and maintenance of projects in the Berks County Behavioral Health HealthChoices Program for Medicaid recipients, including providing oversight of the sub-contracted Behavioral Health Managed Care Organization’s (BH-MCO) Compliance Program.

Requirements

Master’s degree in social or human services.
At least five years of direct clinical experience in a behavioral health setting, to include behavioral healthcare project management.
Equivalent combinations of experience and training may be considered.
Valid Pennsylvania driver’s license with good driving record.
Knowledge of the behavioral health system.
Knowledge of behavioral health project management, including data collection and analysis.
Knowledge of budget development and analysis.
Ability to establish and maintain positive working relationships.
Ability to communicate effectively and diplomatically with professionals and members, both orally and in writing.
Ability to manage multiple priorities in an organized, detail-oriented, and efficient manner.
Ability to work independently with minimal supervision.
Proficiency with standard computer software programs.
Ability to handle stress.

Nice To Haves

If the incumbent is approved by the State of PA to act as an Emergency Services Delegate, then they may be required to assist in providing coverage to perform duties of an Emergency Services Delegate if needed.
May be required to assist on a 7-day, 24-hour rotation program.

Responsibilities

Serve as project lead and ensure compliance for assigned Department of Human Services (DHS) projects, such as Value Based Purchasing (VBP).
Serve as project lead and collaborate with the BH-MCO on strategic planning and assigned projects.
Oversee the BH-MCO’s Compliance/Fraud, Waste and Abuse (FWA) Program to ensure compliance with state and federal requirements, including timely and accurate reporting, work plan monitoring, and collaborating on provider audits, findings, and related interventions.
Review the BH-MCO’s initiatives, policies/procedures, performance standards, and related documents.
Manage the Berks behavioral health provider network to ensure access standards and service needs are met, including review and approval of service descriptions and expansion requests, data and trend analysis to identify service gaps, and program development.
Develop and monitor reinvestment plans to enhance behavioral health services, including budgets, outcomes, and required reporting.
Participate in member-specific cases to ensure medically necessary behavioral health services are provided.
Serve as project lead on departmental assignments.
Complete Emergency Behavioral Health certification as well as mandatory training and clearances.
If the incumbent is approved by the State of PA to act as an Emergency Services Delegate, then they may be required to assist in providing coverage to perform duties of an Emergency Services Delegate if needed.
May be required to assist on a 7-day, 24-hour rotation program.