Behavioral Health Compliance Manager

Description

THE POSITION

Under administrative direction, plans, organizes, develops, coordinates, and directs the behavioral health compliance programs for Ventura County Behavioral Health (VCBH). Ensures compliance with federal, state, and county regulations and policies, including Medi-Cal and Medicare laws related to behavioral health services. Serves as the primary liaison with the Ventura County Health Care Agency (HCA) Compliance Officer/Office, facilitating coordination on compliance matters and ensuring alignment with overarching HCA goals and standards.

Additionally, this position reports to the Chief of Managed Care Operations and liaises with the HCA Compliance Officer/Office to ensure VCBH compliance activities align with county policies, federal and state regulations, and behavioral health-specific requirements. This role focuses on safeguarding the privacy and security of behavioral health patient information, ensuring adherence to Medicaid and Medicare billing/claiming regulations, and implementing compliance policies specific to behavioral health clinical and administrative operations.

WHAT WE OFFER

The County of Ventura offers an attractive compensation and benefits package. In addition to the annual salary an employee within these positions may also be eligible for the following:

• Bilingual Incentive - Incumbents may be eligible for bilingual incentive depending upon operational needs and certification of skill.
• Educational Incentive - Incumbents may also be eligible for an educational incentive of 2.5% for completion of an associate degree, 3.5% for completion of a bachelor’s degree, or 5% for completion of a graduate degree for educational attainments not specifically required by the position.
• Deferred Compensation - Eligible to participate in the County's 401(k) Shared Savings Plan and/or the Section 457 Plan.
• Health Plans - Full-time employees are afforded a flexible credit allowance for purchasing medical, dental, and/or vision insurance from a group of authorized plans.
• Flexible Spending Accounts - Choice of participation in the Flexible Spending Accounts which increase spending power through reimbursement of pre-tax dollars for IRS approved dependent care and health care expenses.
• Pension Plan - Both the County and employees contribute to the County's Retirement Plan and to Social Security. If eligible, reciprocity may be established with other public retirement systems, such as PERS.
• Holidays - 12 paid days per year which includes a scheduled floating holiday.

DEPARTMENT/AGENCY: Health Care Agency - Behavioral Health

PAYROLL TITLE: Senior Program Administrator

Senior Program Administrator is a Management/Confidential classification and is not eligible for overtime compensation. Incumbents in this classification is eligible for benefits at the MB3 level.

The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-term), Intermittent, and Extra Help vacancies for this position only. There is currently one (1) Regular vacancy.

TENTATIVE SCHEDULE

OPENING DATE: February 25, 2025

CLOSING DATE: March 11, 2025 at 5:00 p.m.

Examples Of Duties

Duties may include, but are not limited to the following:

• Oversees the development, implementation, and maintenance of VCBH-specific compliance policies and procedures, including those related to ethics, privacy, and regulatory requirements;
• Collaborates with the HCA Compliance Officer to ensure consistent compliance practices and adherence to federal, state, and local regulations;
• Directs compliance audits and investigations for behavioral health operations, including mental health and substance use disorder services;
• Provides reports on findings and recommends corrective action;
• Monitors compliance with Medi-Cal, Medicare, and other funding program requirements, including billing/claiming standards for behavioral health services;
• Develops and delivers training to VCBH staff on compliance-related topics, such as HIPAA, 42 CFR Part 2, and Medicaid/Medicare fraud, waste, and abuse prevention;
• Tracks changes in regulations affecting behavioral health compliance and updates policies and practices accordingly;
• Provides timely and accurate updates to VCBH leadership and staff on compliance issues, risks, and corrective actions;
• Promotes a culture of compliance and accountability within VCBH through collaboration with program managers, supervisors, and clinical staff;
• Facilitates communication and coordination between VCBH and HCA regarding records requests, regulatory filings, and audits;
• Prepares reports and presentations for internal stakeholders and external regulatory agencies as needed;
• Serves as the compliance point of contact for grievances, appeals, and Notices of Adverse Benefit Determinations (NOABDs);
• Supervises staff, providing guidance and training to ensure effective implementation of compliance policies and procedures; and
• Performs other related duties as required.

Typical Qualifications

These are entrance requirements to the examination process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, and EXPERIENCE
Considerable combination of related education, training, and experience which has led to the acquisition of the required knowledge, skills and abilities. Example of qualifying experience includes:

• A Bachelor's degree from an accredited college or university in Public Health Administration, Behavioral Health Services Administration, Business Administration, or a closely related field; AND
• Four (4) years of compliance-related experience in a behavioral health or healthcare setting, including, but not limited to internal auditing and development of HIPAA compliance programs

NECESSARY SPECIAL REQUIREMENTS

• Three (3) years of supervisory experience
• Intermediate proficiency in Microsoft Word, Excel, and PowerPoint

DESIRED

• A Master’s degree in Public Health Administration, Behavioral Health Services Administration, Business Administration, or a closely related field;
• Experience with compliance administration in a behavioral health setting

KNOWLEDGE, SKILLS, and ABILITIES
Working knowledge of: the principles and techniques of healthcare compliance program management; federal and state regulations, including Medi-Cal, Medicare, HIPAA, and 42 CFR Part 2; behavioral health service delivery systems, including mental health and substance use disorder services; and regulatory requirements for documentation, privacy, and data security.

Skill in: written and oral communication; decision-making; conducting training; project management; and using Microsoft Word, Excel, PowerPoint, and other related software tools.

Ability to: plan, monitor, audit, and evaluate compliance activities and projects; conduct compliance investigations; prepare a variety of reports and recommendations; communicate effectively; plan, organize, and supervise the work of others; collaborate with multidisciplinary teams; and maintain organized and accurate compliance documentation.

Recruitment Process

FINAL FILING DATE : Your application must be received by County of Ventura Human Resources in Ventura, California, no later than 5:00 p.m. on Tuesday, March 11, 2025.

To apply on-line, please refer to our website at www.ventura.org/jobs . If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 South Victoria Avenue, L-1970, Ventura, CA 93009.

LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here for additional information.

Note to Applicants: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume and/or other related documents may be attached to supplement the information in your application and supplemental questionnaire; however, it/they may not be submitted in lieu of the application.

SUPPLEMENTAL QUESTIONNAIRE - qualifying: All applicants are required to complete and submit the questionnaire for this exam AT THE TIME OF FILING. The supplemental questionnaire may be used throughout the exam process to assist in determining each applicant's qualifications and acceptability for the position. Failure to complete and submit the questionnaire may result in the application being removed from consideration.

TRAINING & EXPERIENCE EVALUATION: A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.

NOTE: The selection process will likely consist of an Oral Exam, which may be preceded or replaced with the score from a Training and Experience Evaluation (T&E), contingent upon the size and quality of the candidate pool. In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questions within the application are completed with care and diligence. Responses such as "See Resume" or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation.

ORAL EXAM - 100%: A job-related oral exam will be conducted to evaluate and compare participating applicants' knowledge, skills, and abilities in relation to those factors which job analysis has determined to be essential for successful performance of the job. Applicants must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.

If there are three (3) or fewer qualified applicants, an oral exam will not be conducted. Instead, a score of seventy percent (70%) will be assigned to each application, and each applicant will be placed on the eligible list.

Applicants successfully completing the exam process may be placed on an eligible list for a period of one (1) year.

BACKGROUND INVESTIGATION: A thorough pre-employment, post offer background investigation which may include inquiry into past employment, education, criminal background information and driving record may be required for this position.

For further information about this recruitment, please contact Maritza David by e-mail at Maritza.David@ventura.org or by telephone at (805) 677-5162.

EQUAL EMPLOYMENT OPPORTUNITY: The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

YOUR BENEFITS AS A COUNTY OF VENTURA EMPLOYEE

MANAGEMENT

To learn more about Benefits, Retirement, and the Memorandum of Agreement (MOA), see links below.

• Benefits website or you may call (805) 654-2570.
• Retirement FAQ's
• Memorandum of Agreement

Union Codes:MB3, MB4, MS, MT,MCC, MU

Closing Date/Time: 3/11/2025 5:00 PM Pacific

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• County of Ventura

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