Applied Behavioral Analysis Analyst / Job Req 587478083

PRINCIPAL RESPONSIBILITIES:

This position will work under the direction of the Sr. Director of Behavioral Health and the Senior Medical Director to implement processes to ensure effective delivery of Behavior Health Treatment services. Alongside the Sr. Director of Behavioral Health, this position will achieve quality and productivity standards and ensure compliance with department policies and procedures. The Applied Behavior Analysis Analyst, Behavioral Health is responsible for the daily operation of Behavioral Health Treatment (BHT) services program, including Applied Behavior Analysis (ABA), under the Early and Periodic Screening Diagnostic and Treatment (EPSDT). This includes operational Case and Utilization Management for members who require BHT services. This position will ensure that members receive appropriate provider linkage and assist Case Managers and BH Triage Staff with reviewing assessments and treatment plans submitted by providers for adherence to BHT "best practice" guidelines. The ABA Analyst will collaborate with other internal AAH departments to ensure regulatory compliance. The position will interact with delegates contracted organizations and providers, health networks, and other stakeholders in a manner that promotes collaborative working relationships.

Principal responsibilities include:

• Serves as an BHT/ABA behavioral health expert for internal departments, health networks, and contracted providers.
• Maintains clinical expertise and knowledge of best practices for all relevant clinical areas of BHT/ABA and behavioral health including statutory and regulatory requirements.
• Acts as a liaison to community based and governmental providers that serve members.
• Monitors compliance with federal, state and county contracts and/or Memorandum of Understanding (MOUs), and other requirements set forth by regulatory agencies or funding sources specific to BHT/ABA and behavioral health care services.
• In coordination with Director of QA, support the Plan’s efforts to achieve NCQA accreditation and to maintain all statutory and regulatory requirements on key measures pertaining to BHT/ABA and behavioral health including the review of the policies and practices of delegated entities.
• Reviews activities including progress and barriers towards goals, resolves conflicts or strategizes solutions and adjusts current service plans as needed
• Develops clinical guidelines, policies, and procedures for the provision of BHT/ABA and behavioral health care services.
• Work closely and in collaboration with all staff to maintain open communication among all the clinical departments and create a positive team culture.
• Confers with internal AAH staff as needed to address patterns of utilization and assure that behavioral health care is at an acceptable level of quality.
• Work closely with licensed and unlicensed staff to co-manage the care of complex cases telephonically through regular contact with members, caretakers, healthcare professionals and others involved in the member’s care
• Provides guidance to the BH clinical staff on issues related to BHT/ ABA services provided to members.
• Develops and prepares reports to meet internal, regulatory, contractual and accreditation requirements.
• Participates in clinical discussions with providers and community agencies to encourage the incorporation of behavioral health care aspects into their services and planning efforts
• Coordinates and consults with the Plan’s contracted subject matter experts: including Licensed neuro-psychologists, BCBA’s, neurologists, speech therapists or others as directed by the Senior Director of Behavioral Health to facilitate individual treatment plans and utilization management for members receiving BHT/ABA and/or behavioral health services
• Recommends strategies to enhance existing networks performance as identified.
• Perform other duties, projects or functions as assigned
• In conjunction with compliance, reviews and analyzes reports and policies provided by delegated vendors and participates in on-site audits as requested.
• Works to clarify issues regarding a member status, needs, and goals
• Perform all job functions with integrity and provide timely internal and external customer service in cooperative, professional, and respectful manner.
• Adheres to administration of behavioral health care services including identification and development of clinical practice guidelines and associated trainings.
• Collaborates with the other local agencies focused on special needs, mental health and substance use, including Regional Center, Alameda County Behavioral Health (ACBH), and Drug Medi-Cal Organized Delivery System to ensure smooth transitions across the continuum of health care.

ESSENTIAL FUNCTIONS OF THE JOB

• Communicating effectively and efficiently internally and externally.
• Analyzing reports on all departmental functions.
• Complying with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
• Evaluating data analytics pertaining to medical services and BHT/ABA utilization
• Serve as subject matter expert in BHT/ABA and behavioral health and clinical programs in support of the Triple Aim of improving patient experience of care, health outcomes, and reducing overall cost.
• Overseeing daily work of BHT/ABA Services and leading and participating in internal and external committees and meetings.
• Making oral presentations, as requested

PHYSICAL REQUIREMENTS

• Constant and close visual work at desk or computer.
• Frequent walking and standing.
• Extensive typing using keyboard and/or mouse.
• Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
• Constant sitting and working at desk.
• Frequent lifting of folders, files, binders, and other objects weighing between 0 and 30 lbs.
• Occasional driving of automobiles.

Number of Employees Supervised: 0

MINIMUM QUALIFICATIONS:

EDUCATION OR TRAINING EQUIVALENT TO:

• Board Certified Behavioral Analyst (BCBA) or BCBA-D is required.
• Licensed behavior analysts a preferred
• Doctoral or Master's degree in Social Work, Psychology, Marriage and Family Therapy, Education or other related field is preferred.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• 3 years of experience providing BHT/ABA therapy to children diagnosed with ASD is required.
• 3 years of experience working with health care delivery systems and/or in a public agency serving the related population preferred.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

• Ability to use and manipulate reported data to assess department metrics.
• Experience with Medi-Cal program, Department of HealthCare Services and Department of Managed HealthCare preferred.
• Familiarity with HMO, IPA, and medical group contracting concepts, principles, and practices.
• Experience in use of various computer system software including pharmacy programs, as well as Windows, Word, Excel, Outlook, and PowerPoint.
• Excellent written and verbal communication skills required.
• In depth understanding of behavioral health standards and clinical care best practices.

SALARY RANGE $121,730.28 - $182,595.42 ANNUALLY

The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.